health care access and utilization - utah

1996 Utah Health Status Survey Report

HEALTH CARE ACCESS AND UTILIZATION

Bureau of Surveillance and AnalysisOffice of Public Health Data

For more information contact: Bureau of Surveillance and AnalysisUtah Department of Health288 North 1460 WestBox 142101Salt Lake City, Utah 84114-2101Phone: (801) 538-6108FAX: (801) 536-0947Email: [email protected]

This report is also available on the Internet at URL:http://hlunix.hl.state.ut.us/action2000/reports.html

Health Care Access and Utilization

Bureau of Surveillance and AnalysisOffice of Public Health Data

March 1999

This report can be reproduced and distributed without permission.

Suggested citation

Bureau of Surveillance and Analysis. (1999). Health Care Access and Utilization (1996 Utah Health Status Survey Report). Salt Lake City, UT: Utah Department of Health.

ii

The 1996 Utah Health Status Survey was funded by the Utah State Legislature. The Office ofPublic Health Data, Bureau of Surveillance and Analysis, under the direction of Robert T. Rolfs, MD, MPH,provided general oversight for the project. It is the mission of the Office of Public Health Data to facilitate,coordinate, and assure the appropriate collection, analysis, and interpretation of accurate health data forpurposes of surveillance, policy development, and program planning and evaluation.

1996 Utah HSS Planning Committee

Chair: Lois M. Haggard, PhD, Bureau of Surveillance and Analysis, UDOHStaff: Kim Neerings, Bureau of Surveillance and Analysis, UDOH

Members:Sherrie Ahlstrom, RN, BSN, Tooele County Health DepartmentDenise Beaudoin, MD, MSPH, Chronic Disease Team, UDOHJohn Brockert, MSPH, Bureau of Vital Records and Health Statistics, UDOHKen Buchi, MD, Veteran’s Administration HospitalGary L. Edwards, MS, CHES, Southwest Utah Public Health DepartmentRebecca Giles, BS, CHES, Health Promotion Team, UDOHRich Kerber, PhD, Utah Cancer Registry, University of UtahKirin McInnis, MA, Governor’s Office of Planning and BudgetBarry Nangle, PhD, Bureau of Vital Records, UDOHFineasi Nau, MA, Governor’s Office of Polynesian AffairsLuis Paita, PhD, Office of Health Data Analysis, UDOHLorena Riffo, JD, Governor’s Office of Hispanic AffairsRobert T. Rolfs, MD, MPH, Bureau of Surveillance and Analysis, UDOHDarryl L. Snyder, Bureau of Surveillance and Analysis, UDOHKevin Thompson, MS, Weber/Morgan District Health DepartmentMichael B. Toney, PhD, Population Research Laboratory, Utah State UniversityKim Wixon, MBA, General Services, UDOHWu Xu, PhD, Division of Community and Family Health Services, UDOH

The report was developed and prepared by:

Lois M. Haggard, Ph.D., Office of Public Health DataKim Neerings, Office of Public Health Data

The following individuals reviewed earlier drafts of this report:

Robert T. Rolfs, MD, MPH, Office of Public Health Data

ACKNOWLEDGMENTS

This publication was made possible in part by the PHHS Block Grant from CDC. The contents do notnecessarily represent the official views of CDC.

iii

TABLE OF CONTENTS

Page

Acknowledgments.......................................................................................................... ii

List of Figures and Tables ............................................................................................. v

Preface .......................................................................................................................... iv

Introduction .................................................................................................................. xi

Summary of Findings ...................................................................................................xiii

Highlights ....................................................................................................................... 1

Reference Tables ......................................................................................................... 27

Technical Notes ........................................................................................................... 59

Bibliography................................................................................................................. 67

v

LIST OF FIGURES AND TABLES

Page Number

FigureReference

Table

3 29

4 30

5 31

6 32

7 33

8 33

9 34

10 34

-- 36

11 37

12 37

13 38

14 39

-- 40

Primary Provider: Percentage4 of Persons Who Had No Primary Health Care Provider or Usual Place of Care by Access and Health Status. Utah, 1996.

Characteristics of the Most Recetn Medical and Hospital Visits. Utah, 1996.

Percentage of Utahns According to the Place They Usually Go for Health Care or Advice. Utah, 1996.

Percentage of Persons Who Typically Access Care at a Hospital Emergency Department or Urgent Care Center by Age and Sex. Utah, 1996.

Percentage of Persons Who Typically Access Care at a Hospital Emergency Department or Urgent Care Center by Health Insurance Status. Utah, 1996.

Percentage of Persons Who Typically Access Care at a Hospital Emergency Department or Urgent Care Center by Whether a Problem Was Encountered Accessing Needed Health Care in the Past 12 Months. Utah, 1996.

Primary Provider: Percentage of Utahns According to the Doctor or Place They Usually Go for Medical Care. Utah, 1996.

Percentage of Persons Who Had No Primary Health Care Provider or Usual Source of Care by Age and Sex. Utah, 1996.

Percentage of Persons Who Had No Primary Health Care Provider or Usual Source of Care by Health Insurance Status. Utah, 1996.

Percentage of Persons Who Had No Usual Health Care Provider or Place of Care by Health Status and Health Insurance Coverage. Utah, 1996.

Percentage of Persons Reporting They Were Unable to Get Needed Health Care in the Past 12 Months by Type of Care. Utah, 1996.

Percentage of Persons Reporting They Were Unable to Get Needed Health Care in the Past 12 Months by Health Insurance Status. Utah, 1996.

Percentage of Persons Who Reported They Were Unable to Get Needed Health Care in the Past 12 Months by Health Status and Annual Household Income. Utah, 1996.

Percentage of Persons Who Reported They Were Unable to Get Needed Health Care by Presence of a Medical Condition. Utah, 1996.

vi

Page Number

FigureReference

Table

15 41

16 42

17 43

18 44

-- 45

-- 46

-- 47

19 48

20 49

-- 50

-- 51

-- 52

21 56

Average Number of Outpatient Medical Visits in the Past 12 Months by Age and Sex. Utah, 1996.

Number of Outpatient Medical Visits in the Past 12 Months by Household Income as a Percentage of the Federal Poverty Level. Utah, 1996.

Percentage of Persons Who Had a Routine Preventive Health Visit in the Past 12 Months by Age and Sex. Utah, 1996.

Number of Outpatient Medical Visits in the Past 12 Months by General Health Status. Utah, 1996.

Percentage of Persons Who Had an Overnight Hospital Stay in the Past 12 Months by Annual Household Income. Utah, 1996.

Percentage of Persons Who Had an Overnight Hospital Stay in the Past 12 Months by Presence of a Chronic Medical Condition. Utah, 1996.

Percentage of Persons Who Sought Mental Health Care in the Past 12 Months by Mental Health Status (Last 30 Days). Utah Adults Age 18 or Over, 1996.

Poor Mental Health Status: Percentage of Persons Whose Mental Health Score on the SF12 Was Poorer Than Average (Below Average Mental Health Status) by Primary Provider, Problems with Access, and Health Status. Utah Adults (Age 18 or Over), 1996.

Routine Preventive Health Care: Percentage of Persons Who Had a Routine Preventive Health Visit in the Past 12 Months by Primary Provider, Access and Health Status. Utah, 1996.

Routine Preventive Health Care: Percentage of Persons Who Had a Routine Preventive Health Visit in the Past 12 Months by Selected Demographic Characteristics. Utah, 1996.

Hospitalization: Percentage of Persons Who Had an Overnight Hospital Stay in the Past 12 Months by Sex and Age. Utah, 1996.

Poor Mental Health Status: Percentage of Persons Whose Mental Health Score on the SF12 Was Poorer Than Average (Below Average Mental Health Status) by Selected Deomographic Characteristics. Utah Adults (Age 18 or Over), 1996.

Poor Mental Health Status: Percentage of Persons Whose Mental Health Score on the SF12 Was Poorer Than Average (Below Average Mental Health Status) by Sex and Age. Utah Adults (Age 18 or Over), 1996.

vii

Page Number

FigureReference

Table

22 53

23 55

24 54

-- 56

25 57

Mental Health Care Utilization: Percentage of Persons Who Sought Mental Care in the Past 12 Months by Primary Provider, Problems with Access, and Health Status. Utah Adults (Age 18 or Over), 1996.

Percentage of Adults Who Sought Mental Health Care in the Past 12 Months by Age and Sex. Utah Adults Age 18 or Over, 1996.

Percentage of Adults Who Sought Mental Health Care in the Past 12 Months by Annual Household Income. Utah Adults Age 18 or Over, 1996.

Percentage of Adults Age 18+ Who Sought Care From a Mental Health Professional by Mental Health Status and Household Income as a Percentage of the Federal Poverty Level. Utah, 1996.

Primary Reason Given for Not Seeking Mental Health Services. Utah Adults Age 18 or Over Who Had Below Average Mental Health Status and Considered Seeking But Did Not Seek Mental Health Care, 1996.

ix

PREFACE

The information in this report is based on data collected in the 1996 Utah Health Status Survey.The survey represents the third of its type, with previous surveys conducted in 1986 and 1991. It providesinformation on a variety of topics related to health status and health care delivery systems at statewide andhealth district levels. These topics are presented in separate reports released under the headings listedbelow.

The survey was funded by a one-time legislative appropriation and was designed, analyzed, andreported by the Utah Department of Health, Bureau of Surveillance and Analysis. The survey sample wasdesigned to be representative of Utahns, and is perhaps best described as a weighted probability sampleconsisting of approximately 6,300 households disproportionately stratified by twelve local health districtsthat cover the entire state.

The Gallup Organization conducted the telephone interviews using computer-assisted random digitdialing techniques. In each household, one adult (age 18 or older) was randomly selected to respond tosurvey questions about themselves, about the household as a unit, or with regard to each householdmember. In addition to “core” survey questions that were asked of every household, sets of supplementalquestions were administered to different subsets of the overall sample. The survey results were weighted toreflect the age, sex, geographic distribution, and Hispanic status of the population. The interview processtook place over a three month period from June to August, 1996. The cooperation rate was 66.3%. Adetailed description of the methodology can be found in the Technical Notes section of this report.

The information in this report can be used to facilitate policy and planning decisions. While it isintended primarily for public health program managers, administrators, and other health care professionals inthe public and private health care sectors, the report may also be of interest to anyone wishing to informthemselves on the current health situation in Utah.

Health Insurance CoverageLifestyle Factors: Alcohol, Tobacco, Exercise,

and 5-A-DayHealth Status in Utah: Medical Outcomes

Study SF-12Socio-Economic Status and HealthLimitations of Activities in Utah

Interpersonal Violence in UtahOverview of the 1996 Health Status

SurveyChronic Medical ConditionsInjuries in UtahHypertension and CholesterolMigration Patterns to Utah

xi

INTRODUCTION

Assuring access to health care has been defined by the Institute of Medicine as one of the keyfunctions of government in public health1. In addition to the ability to access medical care for an acutemedical problem, having a primary health care provider, or a “medical home” is also believed to promotehealth. A person’s primary provider has access to his or her medical records, and is able to provide higherquality care by considering the medical and social context of a problem or condition. Routine preventivehealth visits are another way to promote health in the population. Preventive screening tests, such as Papsmear and blood pressure testing, can detect problems early, often while they are curable. Routine preven-tive visits also provide an opportunity for doctors to communicate with patients about healthy lifestylechoices.

The following topics are covered in this report:• Reported problems with access to care• Use of a primary health care provider• Usual point of access to health care and emergency department/urgent care center use• Outpatient medical visits in last 12 months• Routine preventive health visit in last 12 months• Hospital visits in last 12 months• Mental health status (adults age 18+)• Mental health care utilization (adults age 18+)

Information is reported for both adults and children for all but the last two topics. Each topic isreported by age and sex, additional demographic variables such as income, poverty, local health district,and health insurance status, and health status variables such as physical and mental health status. Inaddition, selected analyses are presented that compare health care access and utilization with health statusand personal resources, such as income and health insurance status.

Report highlights are on pages 1 through 25. The information in this report is presented in detail inthe Reference Tables on pages 27 through 57.

1 In 1970 The Institute of Medicine was chartered by the National Academy of Sciences to examine policy andadvise the federal government on matters related to public health. In 1986 the Institute formed The Committee for theStudy of the Future of Public Health to examine issues such as the current definition of “Public Health” and the appropri-ate role of government in assuring the health of the population. The committee’s report, entitled The Future of PublicHealth, was published in 1988. The report concluded that there are three core functions of public health agencies at alllevels of government: assessment, policy development, and assurance.

xiii

SUMMARY OF FINDINGS

• 2.4% of those reported in the survey, or almost 50,000 Utahns, reported that they had a problem obtain-ing needed medical, dental, or mental health care in the 12 months before the survey interview.

» About 2% of Utahns had problems obtaining needed dental care, obtaining medical care was aproblem for about 1% of Utahns, and obtaining mental health care was a problem for less than 1%of Utahns.

» Young adults, age 18-34, were more likely than other age groups to report problems accessingneeded care (5%).

» Persons without health insurance (10%) and those with household incomes below $15,000 (8%)were also likely to report problems obtaining needed health care in the past 12 months.

» Concerns about cost and health insurance were most often cited as reasons for problems obtainingneeded care.

• Most persons (69%) have a family practice or other medical doctor who serves as their primary careprovider. However, 18% of persons in the survey had neither a provider nor a place where they typicallygo for medical care.

» Young adults age 18-34 (30%) and especially males in this age group (39%) were more likely thanother age groups to report no primary provider or usual place of care.

» 40% of those who lacked health insurance also lacked a primary provider or usual place of care.

• Most persons (75%) usually go to a doctor’s office when they need health care or advice. However, asubstantial number (12%, or almost 250,000 persons) would typically go to a hospital emergencydepartment or urgent care center (9% urgent care center, 3% hospital emergency department).

» Persons who had no primary provider (28%) and those who lacked health insurance (21%) weremore likely than average to go to a hospital emergency department or urgent care center for healthcare or advice.

• Males made, on average, 2.9 visits to medical doctors in the past 12 months, compared with 4.0 visitsfor females in all age groups. Certain groups had more medical visits than average:

» Utahns age 65 and over (6.0), especially males age 65 and over (7.4),» Utahns living in poverty (5.7), and those in households with less than $15,000 annual income (5.5),» Utahns with good, fair, or poor health status (5.6), and» Utahns with a chronic medical condition, such as diabetes or heart disease (6.3).

• Only about half (56%) of Utahns had a routine preventive health visit in the past year.» Persons age 65 and over (86%) and persons with a chronic medical condition (73%) were likely to

have had a routine preventive health care visit.» Persons with household incomes under $15,000 (70%) were more likely than other income groups

to have had a routine health visit. The reason for this pattern is not clear. The pattern was appar-ently not due to poorer health status among lower income groups, as it was found among personswith excellent and very good health.

» Those who reported having problems obtaining needed care (68%) were also likely to have had aroutine health visit.

xiv

• 3.8% of Utahns had been hospitalized in the 12 months before the survey.» The percentage was much higher (11%) for Utahns with annual household incomes below $15,000.» Persons with a chronic medical condition were also more likely to have been hospitalized (13%).

• Among adult Utahns, 9% reported that they sought care from a mental health professional in the 12months before the survey.

» 17% of adult Utahns were categorized* as having below-average mental health. Of those Utahns,26% (about 59,000 persons) sought care from a mental health professional.

» Among adult Utahns, 68% were categorized as having average mental health, and 16% with aboveaverage mental health. Of those two groups combined, 5% (about 58,000 persons) sought carefrom a mental health professional.

» Adults with household incomes under $15,000 were more likely than others to be categorized ashaving below-average mental health (32%) and to have sought care from a mental health profes-sional (19%).

» Some Utahns (37,500 persons) had below-average mental health and considered seeking care, butdid not consult a mental health professional. The most frequently cited reasons for delaying carewere cost, financial, and health insurance concerns.

* Mental health status was categorized using the Medical Outcomes Study 12-item health status measure(MOS, SF-12). For more information, see the report entitled Health Status in Utah: The MedicalOutcomes Study SF12. (Bureau of Surveillance and Analysis, 1997)

HIGHLIGHTS

31996 Utah Health Status Survey, Utah Department of Health

Percentage of Persons Reporting They Were Unable to Get Needed Health Care inthe Past 12 Months by Type of Care. Utah, 1996.

0.0%

0.5%

1.0%

1.5%

2.0%

2.5%

3.0%

Medical Care Dental Care Mental Health Care

Per

cent

age

of P

erso

ns

• 2.4% of Utahns (48,400 people) surveyed indicated that they were unable to get neededmedical, dental, or mental health care.

• Of those who reported an access problem, almost 60% indicated that the reason for theproblem was financial or health insurance related.

• Men and women were about equally likely to report having had a problem getting neededcare.

• Young adults (age 18 to 34) were about twice as likely to have had a problem getting neededhealth care.

4 1996 Utah Health Status Survey, Utah Department of Health

Percentage of Persons Reporting They Were Unable to Get Needed Health Care inthe Past 12 Months by Health Insurance Status. Utah, 1996.

0%

2%

4%

6%

8%

10%

12%

14%

16%

Insured Uninsured

Per

cent

age

of P

erso

ns

• Persons who did not have health insurance were especially likely to have had problemsobtaining needed health care.

• Nearly 60% of those who were unable to obtain needed care did have health insurance,however.


Percentage of Persons Who Reported They Were Unable to Get Needed Health Carein the Past 12 Months by Health Status and Annual Household Income. Utah, 1996.

• Those Utahns whose health was less than excellent/very good were most likely to have hadproblems with access to care.

• Access problems were especially common for those with annual household incomes under$15,000.

***0%

2%

4%

6%

8%

10%

12%

14%

16%

Income Under $15K Income $15K to $45K Income Over $45K

Per

cent

age

of P

erso

ns

Excellent/Very Good Health

Good/Fair/Poor Health

*** Sample size insufficient to produce reliable population estimates.


Percentage of Persons Who Reported They Were Unable to Get Needed Health Careby Presence of a Medical Condition. Utah, 1996.

0%

1%

2%

3%

4%

5%

6%

7%

Medical Condition No Medical Condition

Per

cent

age

of P

erso

ns

Medical conditions include Alzheimer's disease, asthma, diabetes, chronic obstructive pulmonary disease, arthritis, stroke, heart disease, hearing impairment, vision impairment, and speech impairment.

• Persons who had a medical condition, such as asthma or diabetes, were more likely to reportproblems with access to health care.


Primary Provider: Percentage of Utahns According to the Doctor or Place TheyUsually Go for Medical Care. Utah, 1996.

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

No One Place Has Place, NoOne Provider

Family/GeneralPractice

Other MedicalDoctor

Mid-LevelPractitioner

Per

cent

age

of P

erso

ns

• 18% of persons in the survey were reported to have no doctor or place where they usually goto get medical care.

• Most persons (69%) have a family practice or other medical doctor to whom they usually gofor their medical care.

• Among Utah’s 12 local health districts, persons living in Salt Lake City/County and TooeleCounty health districts were least likely to have a primary health care provider or usualplace of care (21% and 24%, respectively, reported no usual source of care).


Percentage of Persons Who Had No Primary Health Care Provider or Usual Source ofCare by Age and Sex. Utah, 1996.

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

17 and Under 18 to 34 35 to 49 50 to 64 65 and Over

Per

cent

age

of P

erso

ns

Males

Females

• Young adults (age 18 to 34) and especially young adult males, were most likely to reporthaving no usual care provider or source of care.

• Adult women were more likely to have a usual health care provider than adult men, untilage 65; over that age, men were more likely than women to have a usual source of care.


Percentage of Persons Who Had No Primary Health Care Provider or Usual Source ofCare by Health Insurance Status. Utah, 1996.

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

Insured Uninsured

Per

cent

age

of P

erso

ns

• Persons who had health insurance were much more likely to have a usual health care pro-vider or source of care. Only 15% of insured persons reported having no usual source ofcare, whereas 39% of uninsured persons reported no usual source of care.


Percentage of Persons Who Had No Usual Health Care Provider or Place of Care byHealth Status and Health Insurance Coverage. Utah, 1996.

• Having a usual source of health care was strongly related to having health insurance, re-gardless of a person’s general health status.

0%

10%

20%

30%

40%

50%

60%

Persons Who Had Health Insurance Persons With No Health Insurance

Per

cent

age

of P

erso

ns

Excellent/Very Good Health

Good/Fair/Poor Health


Percentage of Utahns According to the Place They Usually Go for Health Care orAdvice. Utah, 1996.

• Most persons (75%) usually go to a doctor’s office when they need health care or advice.

• However, a significant number (12%, or almost 250,000 persons) would typically go to anurgent care center or hospital emergency department for health care or advice (9% indi-cated “urgent care center” and 3% indicated “hospital emergency room”).

• These results were similar to the answers respondents gave to a question that asked wherehealth care was most recently received (11% urgent care center, 6% emergency depart-ment).

0%

10%

20%

30%

40%

50%

60%

70%

80%

Doctor

's Offic

e

Urgen

t Car

e Cen

ter

Public

Hea

lth C

linic

Hospit

al Emer

genc

y Roo

m

Other H

ospit

al

Milit

ary,

V.A.

Nowhe

reOthe

r

Per

cent

age

of P

erso

ns


Percentage of Persons Who Typically Access Care at a Hospital EmergencyDepartment or Urgent Care Center by Age and Sex. Utah, 1996.

0%

5%

10%

15%

20%

25%

30%


Per

cent

age

of P

erso

ns

Males

Females

• Among adults, males were more likely than females and younger adults were more likelythan older adults or children to use an emergency department or urgent care center as theirusual source of care.

• 20% of males age 18 to 34 reported that the place they “usually go for health care or advice”is a hospital emergency department or urgent care center.


Percentage of Persons Who Typically Access Care at a Hospital EmergencyDepartment or Urgent Care Center by Health Insurance Status. Utah, 1996.

0%

5%

10%

15%

20%

25%

30%

Insured Uninsured

Per

cent

age

of P

erso

ns

• Persons who were without health insurance were more likely to report that they typically goto a hospital emergency department or urgent care center for health care or advice.

• Persons with low incomes and those with less than a high school education were also morelikely than others to seek care in urgent care settings.


Percentage of Persons Who Typically Access Care at a Hospital EmergencyDepartment or Urgent Care Center by Whether a Problem Was Encountered

Accessing Needed Health Care in the Past 12 Months. Utah, 1996.

0%

5%

10%

15%

20%

25%

30%

35%

40%

No Problem Accessing Care Problem Accessing Care

Per

cent

age

of P

erso

ns

• Persons who were reported to have had a problem obtaining needed health care were morethan twice as likely (25%) as others (12%) to use a hospital emergency department or urgentcare center as a usual source of care.


Average Number of Outpatient Medical Visits in the Past 12 Months by Age and Sex.Utah, 1996.

0

2

4

6

8

10

12

14


Num

ber

of O

utpa

tient

Med

ical

Vis

its

Males

Females

• 82% of the Utahns included in the survey had at least one visit with a medical doctor in thepast 12 months. A medical doctor was defined as “general practitioners, as well as special-ists (such as dermatologist or orthopedist, etc.) and osteopaths. Do not include visits to adentist, chiropractor, psychotherapist or other non-medical doctors.”

• Women averaged more outpatient medical visits (4.0) than men (2.9), but men age 65 or overreported more visits than any other age/sex group (7.4).

• Data from the 1996 National Ambulatory Medical Care Survey indicate that women in theU.S. had an average of 3.9 visits, and men had 2.9 visits per year.


Number of Outpatient Medical Visits in the Past 12 Months by Household Income asa Percentage of the Federal Poverty Level. Utah, 1996.

0

1

2

3

4

5

6

7

8

9

<=100% 101%-200% 201%-300% >=301%

Num

ber

of O

utpa

tient

Med

ical

Vis

its

Household income expressed as a percentage of the federal poverty level.

• Household income as a percentage of poverty was related to medical visits. People in higherincome groups had, on average, fewer visits in the past year than did people with lowerincome.

• A similar pattern was found for annual household income without regard to the povertylevel. The 1996 Utah Health Status Survey report, Socioeconomic Status and Health in Utah,reported that Utahns with low incomes have more health problems, on average, than dothose with higher income levels.


Number of Outpatient Medical Visits in the Past 12 Months by General HealthStatus. Utah, 1996.

0

1

2

3

4

5

6

7

8

Very Good, Excellent Good, Fair, Poor

Num

ber

of O

utpa

tient

Med

ical

Vis

its

• Persons who were reported to be in very good or excellent health had fewer medical visits(2.7) than those whose health was good, fair, or poor (5.6).


Percentage of Persons Who Had a Routine Preventive Health Visit in the Past 12Months by Age and Sex. Utah, 1996.

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%


Per

cent

age

of P

erso

ns

Males

Females

• Older adults were most likely to have had a routine preventive health visit. 93.5% of menage 65 and over had a preventive health visit in the past 12 months.

• 55% of children age 17 and under had a preventive health care visit in the past 12 months.

• 78% of children age 4 and under had at least one preventive health visit in the past 12months. Clinical guidelines (American Association of Pediatrics and National Center forEducation in Maternal and Child Health) recommend well child visits annually for childrenage two through five, and more often for younger children.


Percentage of Persons Who Had an Overnight Hospital Stay in the Past 12 Months byAnnual Household Income. Utah, 1996.

0%

5%

10%

15%

20%

25%

<=$15,000 $15,000-$35,000 $35,000-$55,000 >=$55,000

Per

cent

age

of P

erso

ns

• 3.8% of Utahns had been hospitalized in the 12 months before the survey. The percentagewas much higher (11.4%) for Utahns with annual household incomes below $15,000.

• Older persons were much more likely to have been hospitalized. About one in five personsage 65 or over had been hospitalized in the past year.


Percentage of Persons Who Had an Overnight Hospital Stay in the Past 12 Months byPresence of a Chronic Medical Condition. Utah, 1996.

• Utahns with a chronic medical condition, such as asthma, diabetes, or heart disease, weremuch more likely than others to have been hospitalized (13% vs. 2%).

0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

20%

Medical Condition No Medical Condition

Per

cent

age

of P

erso

ns

Medical conditions included Alzheimer's disease, asthma, diabetes, chronic obstructive pulmonary disease, arthritis, stroke, heart disease, hearing impairment, vision impairment, and speech impairment.


Percentage of Persons Who Sought Mental Health Care in the Past 12 Months byMental Health Status (Last 30 Days). Utah Adults Age 18 or Over, 1996.

• 9% of adult Utahns reported that they sought care from a mental health professional in the12 months before the survey.

• The Medical Outcomes Study SF-12 health status measure (MOS SF-12), which assessesphysical and mental health status in the past 30 days, was administered to the survey re-spondents.

• 68% of adult Utahns were categorized as having average and 16% above average mentalhealth. Of those two groups combined, 5%, or about 58,000 persons, sought care from amental health professional.

• 17% of adult Utahns were categorized as having below average mental health. Of thoseUtahns, 26% or about 59,000 persons, sought care from a mental health professional.

0%

5%

10%

15%

20%

25%

30%

35%

Average or Above Average Below Average Mental Health

Per

cent

age

of A

dults


Percentage of Adults Who Sought Mental Health Care in the Past 12 Months by Ageand Sex. Utah Adults Age 18 or Over, 1996.

0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

20%

18 to 34 35 to 49 50 to 64 65 and Over

Per

cent

age

of A

dults

Males

Females

• Young adult females were more likely than others to have sought mental health care in thepast 12 months.

• Females of all ages were more likely than males to have reported below-average mentalhealth status. It is not clear whether the MOS SF-12 measure accurately detects a higherprevalence of mental health problems in females than males, or whether there is bias in theway males and females respond to the survey questions. For instance, males have higherrates of death from suicide, and higher rates of hospitalization for alcohol and drug abuse,which suggest that mental health problems may manifest themselves differently in men thanwomen.


Percentage of Adults Who Sought Mental Health Care in the Past 12 Months byAnnual Household Income. Utah Adults Age 18 or Over, 1996.

• Adult Utahns with lower incomes (under $15,000) were more likely than others to havesought mental health care in the past 12 months (19% sought care).

• Adult Utahns with annual household incomes below $15,000 were almost three times aslikely as adult Utahns with incomes over $55,000 to have been categorized as having below-average mental health (32% vs. 11%).

• The relationship between physical and mental health status and income has been well-documented. Poor health status can result from low socio-economic status, but low socio-economic status can also result from having health problems that limit one’s ability to workand seek higher education levels.

0%

5%

10%

15%

20%

25%

30%

<=$15,000 $15,000-$35,000 $35,000-$55,000 >=$55,000

Per

cent

age

of A

dults


Percentage of Adults Age 18+ Who Sought Care From a Mental Health Professionalby Mental Health Status and Household Income as a Percentage of the Federal

Poverty Level. Utah, 1996.

• The likelihood of seeking mental health care was much greater for persons with belowaverage mental health status regardless of whether a person was living in poverty.

***0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

Income Less Than 100% of PovertyLevel

Income Greater Than 100% of PovertyLevel

Per

cent

age

of A

dults

Below Average Mental Health

Average Mental Health

Above Average Mental Health

Medical Outcomes Study (MOS) SF-12 measure for physical and mental health status. For more information, see Bureau of Surveillance and Analysis. (1997). Health Status in Utah: The Medical Outcomes Study SF-12 (1996 Health Status Survey Report). Salt Lake City, UT: Utah Department of Health.*** Sample size insufficient to produce reliable population estimates.


Primary Reason Given for Not Seeking Mental Health Services. Utah Adults Age 18or Over Who Had Below Average Mental Health Status and Considered Seeking But

Did Not Seek Mental Health Care, 1996.

***0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

Cost,Insurance,FinancialReasons

Self-Help TimeConstraints

No Reason,Put it Off

Decided ItWas Not

Necessary

Did NotKnow

Where ToGo

Went toM.D., Got

Prescription

Other

Per

cent

age

of A

dults


• 227,000 adult Utahns were categorized with below-average mental health. Of those, only59,000 sought help from a mental health professional.

• An additional 38,000 persons with below average mental health considered seeking help, butdid not. We asked those Utahns why they did not seek help. The most common reason,cited by 34% of those we asked, involved the cost of care, or other health insurance orfinancial concerns.

REFERENCETABLES


Table 1. Access to Care: Percentage of Persons Reporting They Were Unable to Get Needed Health Careby Sex and Age. Utah 1996.

Utah Population Distribution

Survey Estimates of Utahns Who Had Access Problems

Item/Demographic SubgroupPercentage Distribution

Number of

Persons1

Percentage of Persons

Reporting Access

Problem2

Number of

Persons1, 3

Percentage Distribution of

Persons Who Had Access Problem

by Category3

Type of Health Care for Which a Problem Was Reported, All UtahnsMedical Care 100.0% 1,991,800 1.3% + 0.5% 25,700 100.0%Dental Care 100.0% 1,991,800 1.9% + 0.6% 38,000 100.0%Mental Health Care 100.0% 1,991,800 0.6% + 0.3% 11,800 100.0%

Any Access Problem (One or More:Medical, Dental, or Mental Health) 100.0% 1,991,800 2.4% + 0.6% 48,400 100.0%

Reason Reported for Access ProblemFinancial/Insurance 28,700 59.4%Inconvenience 3,900 8.1%Afraid/Embarrassed *** ***Doesn't Like Doctors *** ***Problem Getting Appointment 1,700 3.5%No Doctor Available *** ***Other Reason 6,000 12.4%Total, Utahns Reporting Access Problem 48,400 100.0%

SexMales 49.5% 986,400 2.3% + 0.9% 22,200 45.9%Females 50.5% 1,005,400 2.6% + 0.9% 26,200 54.1%Total, All Utahns 100.0% 1,991,800 2.4% + 0.6% 48,400 100.0%

Age Group17 and Under 32.6% 648,600 0.7% + 0.5% 4,700 9.7%18 to 34 27.2% 541,100 5.1% + 1.8% 27,700 57.2%35 to 49 20.3% 403,900 2.8% + 1.4% 11,200 23.1%50 to 64 10.6% 211,700 1.6% + 1.4% 3,400 7.0%65 and Over 9.4% 186,500 *** + *** *** ***Total, All Utahns 100.0% 1,991,800 2.4% + 0.6% 48,400 100.0%

Sex and AgeMales, 17 and Under 16.7% 332,900 1.1% + 0.9% 3,500 7.2%Males, 18 to 34 13.4% 267,600 4.2% + 2.3% 11,100 22.9%Males, 35 to 49 10.1% 201,200 3.0% + 2.3% 6,100 12.6%Males, 50 to 64 5.2% 103,900 0.7% + 0.7% 700 1.4%Males, 65 and Over 4.1% 80,900 *** + *** *** ***Females, 17 and Under 15.8% 315,700 0.4% + 0.3% 1,200 2.5%Females, 18 to 34 13.7% 273,400 6.1% + 2.7% 16,500 34.1%Females, 35 to 49 10.2% 202,700 2.5% + 1.6% 5,100 10.5%Females, 50 to 64 5.4% 107,900 *** + *** *** ***Females, 65 and Over 5.3% 105,600 *** + *** *** ***Total, All Utahns 100.0% 1,991,800 2.4% + 0.6% 48,400 100.0%

1 Rounded to the nearest 100 persons.

2 Plus or minus 95% confidence interval

3 Figures in these columns may not sum to the totals because of missing values on the grouping variables.*** Sample size insufficient to produce reliable population estimates.


Table 2. Access to Care: Percentage of Persons Reporting They Were Unableto Get Needed Health Careby Selected Demographic Characteristics. Utah 1996.



Demographic SubgroupPercentage Distribution

Number of

Persons1


Reporting Access

Problem2

Number of

Persons1, 3



by Category

Local Health DistrictBear River 6.1% 122,300 2.5% + 1.8% 3,000 6.2%Central 2.9% 58,600 3.5% + 2.0% 2,000 4.1%Davis 11.0% 219,900 0.4% + 0.4% 800 1.7%Salt Lake 41.3% 823,400 2.4% + 1.2% 19,800 41.1%Southeastern 2.7% 53,500 5.8% + 2.8% 3,100 6.4%Southwest 5.6% 111,100 2.3% + 1.6% 2,600 5.4%Summit 1.1% 22,400 2.7% + 2.2% 600 1.2%Tooele 1.4% 26,900 2.0% + 1.6% 500 1.0%TriCounty 1.9% 38,500 3.3% + 2.2% 1,300 2.7%Utah County 15.9% 316,200 2.5% + 1.7% 8,000 16.6%Wasatch 0.6% 12,200 4.3% + 2.3% 500 1.0%Weber-Morgan 9.4% 186,600 3.2% + 1.8% 6,000 12.4%Total, All Utahns 100.0% 1,991,800 2.4% + 0.6% 48,400 100.0%

Health Insurance StatusInsured 90.5% 1,802,000 1.6% + 0.5% 28,100 59.4%Uninsured 9.5% 189,800 10.1% + 4.1% 19,200 40.6%Total, All Utahns 100.0% 1,991,800 2.4% + 0.6% 48,400 100.0%

Persons Who Had Health InsuranceExcellent/Very Good Health 63.9% 1,273,300 1.0% + 0.4% 12,500 43.4%Good/Fair/Poor Health 26.5% 528,700 3.1% + 1.4% 16,300 56.6%Total Insured 90.5% 1,802,000 1.6% + 0.5% 28,100 100.0%

Persons With No Health InsuranceExcellent/Very Good Health 6.4% 126,800 8.6% + 5.1% 10,900 58.0%Good/Fair/Poor Health 3.2% 63,000 12.5% + 6.8% 7,900 42.0%Total Uninsured 9.5% 189,800 10.1% + 4.1% 19,200 100.0%

Household Poverty Level4

<=100% 7.1% 141,400 7.3% + 4.2% 10,300 22.2%101%-200% 27.3% 543,600 3.9% + 1.5% 21,100 45.4%201%-300% 26.8% 533,600 1.3% + 0.7% 6,800 14.6%>=301% 38.8% 772,800 1.1% + 0.7% 8,300 17.8%Total, All Utahns 100.0% 1,991,800 2.4% + 0.6% 48,400 100.0%

Income Less Than 100% of Poverty LevelExcellent/Very Good Health 4.1% 82,200 *** + *** *** ***Good/Fair/Poor Health 3.0% 59,200 9.2% + 5.7% 5,400 52.4%Total <100% of Poverty Level 7.1% 141,400 7.3% + 4.2% 10,300 100.0%

Income Greater Than 100% of Poverty LevelExcellent/Very Good Health 67.2% 1,337,600 1.2% + 0.5% 16,600 45.2%Good/Fair/Poor Health 25.7% 512,500 3.9% + 1.7% 20,100 54.8%Total >100% of Poverty Level 92.9% 1,850,000 2.0% + 0.6% 36,630 100.0%


Table 2. (Continued)




Number of

Persons1


Reporting Access

Problem2

Number of

Persons1, 3



by Category

Annual Household Income<=$15,000 6.7% 133,300 8.2% + 4.3% 10,900 22.5%$15,000-$35,000 29.9% 595,300 3.8% + 1.4% 22,500 46.5%$35,000-$55,000 33.3% 663,300 1.4% + 0.7% 9,000 18.6%>=$55,000 30.1% 599,500 *** + *** *** ***Total, All Utahns 100.0% 1,991,800 2.4% + 0.6% 48,400 100.0%

Income Under $15,000Excellent/Very Good Health 3.5% 69,000 *** + *** *** ***Good/Fair/Poor Health 3.2% 64,300 9.7% + 5.5% 6,200 56.9%Total Under $15,000 6.7% 133,300 8.2% + 4.3% 10,900 100.0%

Income $15,000 to $45,000Excellent/Very Good Health 32.9% 654,900 2.2% + 0.9% 14,300 52.0%Good/Fair/Poor Health 15.4% 305,700 4.3% + 2.2% 13,200 48.0%Total $15,000 to $45,000 48.2% 960,600 2.9% + 0.9% 27,500 100.0%

Income Over $45,000Excellent/Very Good Health 35.0% 696,300 0.3% + 0.3% 2,100 25.3%Good/Fair/Poor Health 10.1% 201,800 3.1% + 2.7% 6,200 74.7%Total Over $45,000 45.1% 898,100 0.9% + 0.7% 8,300 100.0%

Education Level (Age 18 and Over)High School Grad or Less 36.5% 490,300 3.3% + 1.4% 16,300 37.3%Some College or Vocation Degree 37.3% 501,000 3.3% + 1.4% 16,500 37.8%Four-Year College Graduate 26.2% 351,900 3.1% + 1.8% 10,900 24.9%Total, Adult Utahns (Age 18+) 100.0% 1,343,200 3.3% + 0.9% 44,300 100.0%

Marital Status (Age 18 and over)Married 68.4% 918,700 2.8% + 1.1% 26,000 59.5%Divorced, Widowed, Separated 13.4% 180,000 6.1% + 2.9% 10,900 24.9%Never Married 18.2% 244,500 2.8% + 1.7% 6,800 15.6%Total, Adult Utahns (Age 18+) 100.0% 1,343,200 3.3% + 0.9% 44,300 100.0%

Wasatch Front Residence5

Wasatch Front 77.3% 1,539,500 2.7% + 0.8% 41,000 75.1%Non-Wasatch Front 22.7% 452,100 3.0% + 0.8% 13,600 24.9%Total, All Utahns 100.0% 1,991,800 2.4% + 0.6% 48,400 100.0%



3 Figures in these columns may not sum to the totals because of missing values on the grouping variables.

4 Household income expressed as a percentage of the federal poverty level.

5 Wasatch Front counties include Salt Lake, Utah, Davis, and Weber counties.*** Sample size insufficient to produce reliable population estimates.


Table 3. Access to Care: Percentage of Persons Reporting They Were Unableto Get Needed Health Careby Various Indicators of Health Status. Utah 1996.



Health Status SubgroupPercentage Distribution

Number of

Persons1


Reporting Access

Problem2

Number of

Persons1, 3



by Category

General Health StatusVery Good, Excellent 70.0% 1,394,300 1.7% + 0.6% 23,000 47.0%Good, Fair, Poor 30.0% 597,500 4.3% + 1.5% 25,900 53.0%Total, All Utahns 100.0% 1,991,800 2.4% + 0.6% 48,400 100.0%

SF-12 Physical Health Status Composite Score (Age 18 and Over)4

Average or Above Average 81.2% 1,090,700 2.7% + 0.9% 29,300 68.0%Below Average Physical Health 18.8% 252,500 5.5% + 2.5% 13,800 32.0%Total, Adult Utahns (Age 18+) 100.0% 1,343,200 3.3% + 0.9% 44,300 100.0%

SF-12 Mental Health Status Composite Score (Age 18 and Over)4

Average or Above Average 83.1% 1,116,200 2.0% + 0.8% 22,500 51.1%Below Average Mental Health 16.9% 227,000 9.5% + 3.8% 21,500 48.9%Total, Adult Utahns (Age 18+) 100.0% 1,343,200 3.3% + 0.9% 44,300 100.0%

Presence of a Chronic Medical Condition5

Medical Condition 20.9% 416,300 4.5% + 1.8% 18,700 39.0%No Medical Condition 79.1% 1,575,500 1.9% + 0.6% 29,300 61.0%Total, All Utahns 100.0% 1,991,800 2.4% + 0.6% 48,400 100.0%




4 Medical Outcomes Study (MOS) SF-12 measure for physical and mental health status. For more information, see Bureau of

Surveillance and Analysis. (1997). Health Status in Utah: The Medical Outcomes Study SF-12 (1996 Health Status Survey

Report). Salt Lake City, UT: Utah Department of Health.

5 Medical conditions include Alzheimer's disease, asthma, diabetes, chronic obstructive pulmonary disease, arthritis, stroke, heart disease, hearing impairment, vision impairment, and speech impairment.


Table 4. Primary Provider: Percentage of Persons Who Had No Primary Health Care Provider or Usual Place of Careby Sex and Age. Utah 1996.


Survey Estimates of Utahns Who Had No Primary Provider or Usual Place of Care


Number of

Persons1

Percentage of Persons With No Primary

Provider2

Number of

Persons1, 3


Persons With No Primary Provider

by Category

Usual Doctor or Place of Medical CareNo One Place 17.8% 354,500 Has Place, No One Provider 9.9% 197,200 Family/General Practice 41.5% 825,800 Other Medical Doctor 27.8% 554,100 Mid-Level Practitioner 3.0% 60,200 Total, All Utahns 100.0% 1,991,800

No Primary Health Care Provider orUsual Place of Care 100.0% 1,991,800 17.8% + 1.8% 354,500 100.0%


Age Group17 and Under 32.6% 648,600 11.8% + 2.4% 76,800 21.6%18 to 34 27.2% 541,100 30.3% + 4.5% 163,800 46.1%35 to 49 20.3% 403,900 16.4% + 3.9% 66,300 18.7%50 to 64 10.6% 211,700 12.4% + 4.3% 26,100 7.3%65 and Over 9.4% 186,500 12.0% + 3.2% 22,400 6.3%Total, All Utahns 100.0% 1,991,800 17.8% + 1.8% 354,500 100.0%

Sex and AgeMales, 17 and Under 16.7% 332,900 12.0% + 3.5% 39,800 11.2%Males, 18 to 34 13.4% 267,600 38.7% + 7.1% 103,500 29.1%Males, 35 to 49 10.1% 201,200 19.5% + 6.1% 39,300 11.0%Males, 50 to 64 5.2% 103,900 17.9% + 7.6% 18,600 5.2%Males, 65 and Over 4.1% 80,900 8.6% + 3.3% 6,900 1.9%Females, 17 and Under 15.8% 315,700 11.7% + 3.4% 37,000 10.4%Females, 18 to 34 13.7% 273,400 22.2% + 5.2% 60,700 17.1%Females, 35 to 49 10.2% 202,700 13.2% + 4.7% 26,800 7.5%Females, 50 to 64 5.4% 107,900 7.3% + 4.0% 7,800 2.2%Females, 65 and Over 5.3% 105,600 14.7% + 5.0% 15,500 4.4%Total, All Utahns 100.0% 1,991,800 17.8% + 1.8% 354,500 100.0%





Table 5. Primary Provider: Percentage of Persons Who Had No Primary Health Care Provider or Usual Place of Careby Selected Demographic Characteristics. Utah 1996.




Number of

Persons1


Provider2

Number of

Persons1, 3



by Category

Local Health DistrictBear River 6.1% 122,300 15.0% + 3.8% 18,400 5.2%Central 2.9% 58,600 12.2% + 4.0% 7,100 2.0%Davis 11.0% 219,900 12.3% + 3.6% 27,100 7.7%Salt Lake 41.3% 823,400 21.1% + 3.7% 173,400 49.0%Southeastern 2.7% 53,500 18.2% + 4.6% 9,700 2.7%Southwest 5.6% 111,100 18.7% + 4.6% 20,800 5.9%Summit 1.1% 22,400 18.2% + 4.6% 4,100 1.2%Tooele 1.4% 26,900 24.2% + 5.0% 6,500 1.8%TriCounty 1.9% 38,500 15.4% + 4.1% 5,900 1.7%Utah County 15.9% 316,200 15.8% + 4.2% 50,100 14.1%Wasatch 0.6% 12,200 14.8% + 3.8% 1,800 0.5%Weber-Morgan 9.4% 186,600 15.6% + 4.1% 29,200 8.2%Total, All Utahns 100.0% 1,991,800 17.8% + 1.8% 354,500 100.0%


Persons Who Had Health InsuranceExcellent/Very Good Health 63.9% 1,273,300 15.4% + 2.0% 195,800 71.0%Good/Fair/Poor Health 26.5% 528,700 15.1% + 3.3% 80,000 29.0%Total Insured 90.5% 1,802,000 15.3% + 1.7% 275,300 100.0%

Persons With No Health InsuranceExcellent/Very Good Health 6.4% 126,800 40.5% + 9.6% 51,400 68.8%Good/Fair/Poor Health 3.2% 63,000 36.9% + 13.5% 23,300 31.2%Total Uninsured 9.5% 189,800 39.1% + 7.8% 74,200 100.0%


<=100% 7.1% 141,400 18.4% + 5.6% 26,000 7.6%101%-200% 27.3% 543,600 21.0% + 4.0% 114,300 33.3%201%-300% 26.8% 533,600 16.5% + 4.2% 87,900 25.6%>=301% 38.8% 772,800 14.9% + 2.4% 115,300 33.6%Total, All Utahns 100.0% 1,991,800 17.8% + 1.8% 354,500 100.0%

Income Less Than 100% of Poverty LevelExcellent/Very Good Health 4.1% 82,200 20.7% + 8.2% 17,000 64.4%Good/Fair/Poor Health 3.0% 59,200 15.8% + 7.5% 9,400 35.6%Total <100% of Poverty Level 7.1% 141,400 18.4% + 5.6% 26,000 7.6%

Income Greater Than 100% of Poverty LevelExcellent/Very Good Health 67.2% 1,337,600 16.9% + 2.2% 225,400 70.7%Good/Fair/Poor Health 25.7% 512,500 18.3% + 4.2% 93,600 29.3%Total >100% of Poverty Level 92.9% 1,850,000 17.2% + 2.0% 318,800 100.0%






Number of

Persons1


Provider2

Number of

Persons1, 3



by Category

Annual Household Income<=$15,000 6.7% 133,300 19.0% + 5.3% 25,400 7.4%$15,000-$35,000 29.9% 595,300 22.1% + 3.6% 131,300 38.2%$35,000-$55,000 33.3% 663,300 15.3% + 3.3% 101,300 29.5%>=$55,000 30.1% 599,500 14.3% + 3.5% 85,700 24.9%Total, All Utahns 100.0% 1,991,800 17.8% + 1.8% 354,500 100.0%

Income Under $15KExcellent/Very Good Health 3.5% 69,000 21.7% + 8.4% 15,000 58.1%Good/Fair/Poor Health 3.2% 64,300 16.7% + 6.5% 10,800 41.9%Total Under $15K 6.7% 133,300 19.0% + 5.3% 25,400 100.0%

Income $15K to $45KExcellent/Very Good Health 32.9% 654,900 20.2% + 3.2% 132,300 71.5%Good/Fair/Poor Health 15.4% 305,700 17.3% + 4.9% 52,800 28.5%Total $15K to $45K 48.2% 960,600 19.3% + 2.7% 185,300 100.0%

Income Over $45KExcellent/Very Good Health 35.0% 696,300 13.5% + 3.1% 94,100 70.4%Good/Fair/Poor Health 10.1% 201,800 19.6% + 7.7% 39,500 29.6%Total Over $45K 45.1% 898,100 14.9% + 2.9% 133,400 100.0%









5 Wasatch Front counties include Salt Lake, Utah, Davis, and Weber counties.*** Sample size insufficient to produce reliable population estimates.


Table 6. Primary Provider: Percentage of Persons Who Had No Primary Health Care Provider or Usual Place of Careby Access and Health Status. Utah 1996.



Access/Health Status SubgroupPercentage Distribution

Number of

Persons1


Provider2

Number of

Persons1, 3



by Category

Any Access ProblemNo Problem Accessing Care 97.6% 1,944,000 *** + *** *** ***Problem Accessing Care 2.4% 47,800 17.6% + 1.8% 8,400 2.4%Total, All Utahns 100.0% 1,991,800 17.8% + 1.8% 354,500 100.0%

















Table 7. Point of Health Care Access: Percentage of Persons Who TypicallyAccess Care at a Hospital Emergency Room or Urgent Care Centerby Sex and Age. Utah 1996.


Survey Estimates of Utahns Who Access Care at Hospital E.R. or Urgent Care Center (U.C.C.)


Number of

Persons1


Accessing at E.R.

or U.C.C.2Number of

Persons1, 3


Persons Accessing at E.R. or U.C.C. by Category

Usual Point of Access for Medical CareDoctor's Office 74.8% 1,489,700 Urgent Care Center 9.2% 182,400 Public Health Clinic 7.5% 149,600 Hospital Emergency Room 3.0% 60,400 Other Hospital 1.8% 35,900 Military, V.A. 1.2% 23,700 Nowhere 0.9% 17,100 Other 2.0% 39,000 Total, All Utahns 100.0% 1,991,800

Typical Point of Access is Hospital E.R. or Urgent Care Center 100.0% 1,991,800 12.2% + 1.6% 242,800 100.0%


Age Group17 and Under 32.6% 648,600 8.1% + 1.9% 52,600 22.1%18 to 34 27.2% 541,100 16.8% + 3.4% 90,700 38.1%35 to 49 20.3% 403,900 16.1% + 4.8% 65,200 27.4%50 to 64 10.6% 211,700 8.3% + 4.7% 17,500 7.4%65 and Over 9.4% 186,500 6.3% + 2.2% 11,800 5.0%Total, All Utahns 100.0% 1,991,800 12.2% + 1.6% 242,800 100.0%

Sex and AgeMales, 17 and Under 16.7% 332,900 7.4% + 2.5% 24,500 10.3%Males, 18 to 34 13.4% 267,600 20.8% + 5.2% 55,700 23.3%Males, 35 to 49 10.1% 201,200 18.9% + 7.2% 38,000 15.9%Males, 50 to 64 5.2% 103,900 14.0% + 9.3% 14,500 6.1%Males, 65 and Over 4.1% 80,900 8.0% + 4.2% 6,500 2.7%Females, 17 and Under 15.8% 315,700 8.9% + 2.9% 28,100 11.8%Females, 18 to 34 13.7% 273,400 13.0% + 4.6% 35,600 14.9%Females, 35 to 49 10.2% 202,700 13.4% + 6.3% 27,100 11.3%Females, 50 to 64 5.4% 107,900 3.1% + 1.6% 3,400 1.4%Females, 65 and Over 5.3% 105,600 5.1% + 2.2% 5,400 2.3%Total, All Utahns 100.0% 1,991,800 12.2% + 1.6% 242,800 100.0%





Table 8. Point of Health Care Access: Percentage of Persons Who TypicallyAccess Care at a Hospital Emergency Room or Urgent Care Centerby Selected Demographic Characteristics. Utah 1996.




Number of

Persons1


Accessing at E.R.

or U.C.C.2Number of

Persons1, 3



Local Health DistrictBear River 6.1% 122,300 8.9% + 3.3% 10,800 4.4%Central 2.9% 58,600 10.4% + 3.4% 6,100 2.5%Davis 11.0% 219,900 10.1% + 3.4% 22,100 9.1%Salt Lake 41.3% 823,400 14.6% + 3.4% 120,500 49.6%Southeastern 2.7% 53,500 9.7% + 3.5% 5,200 2.1%Southwest 5.6% 111,100 9.6% + 3.4% 10,700 4.4%Summit 1.1% 22,400 16.0% + 4.4% 3,600 1.5%Tooele 1.4% 26,900 16.2% + 4.2% 4,400 1.8%TriCounty 1.9% 38,500 9.5% + 3.2% 3,600 1.5%Utah County 15.9% 316,200 8.6% + 3.1% 27,100 11.1%Wasatch 0.6% 12,200 12.7% + 3.3% 1,500 0.6%Weber-Morgan 9.4% 186,600 14.8% + 4.2% 27,500 11.3%Total, All Utahns 100.0% 1,991,800 12.2% + 1.6% 242,800 100.0%



<=100% 7.1% 141,400 17.9% + 6.7% 25,200 10.3%101%-200% 27.3% 543,600 13.9% + 3.9% 75,400 30.9%201%-300% 26.8% 533,600 10.9% + 3.7% 58,100 23.8%>=301% 38.8% 772,800 11.1% + 2.1% 85,700 35.1%Total, All Utahns 100.0% 1,991,800 12.2% + 1.6% 242,800 100.0%










5 Wasatch Front counties include Salt Lake, Utah, Davis, and Weber counties.


Table 9. Point of Health Care Access: Percentage of Persons Who TypicallyAccess Care at a Hospital Emergency Room or Urgent Care Centerby Primary Provider, Access and Health Status. Utah 1996.



Primary Provider/Access/Health Status Subgroup

Percentage Distribution

Number of

Persons1


Accessing at E.R.

or U.C.C.2Number of

Persons1, 3



Primary Provider or Usual Place of CareHas Primary Provider 82.2% 1,637,300 9.1% + 1.7% 148,300 59.9%No Primary Provider 17.8% 354,500 28.0% + 5.2% 99,100 40.1%Total, All Utahns 100.0% 1,991,800 12.2% + 1.6% 242,800 100.0%

Any Access ProblemNo Problem Accessing Care 97.6% 1,944,000 11.9% + 1.7% 231,500 95.0%Problem Accessing Care 2.4% 47,800 25.3% + 12.4% 12,100 5.0%Total, All Utahns 100.0% 1,991,800 12.2% + 1.6% 242,800 100.0%
















Table 10. Characteristics of the Most Recent Medical and Hospital VisitsUtah 1996.

Survey Estimates for Characteristics of Most Recent Medical Visit

Characteristic

Percentage

Distribution2

Number of

Persons1, 3

Had a visit with a medical doctor in the previous 12 months?Had a visit 81.6% + 4.2% 1,625,300 Did not have a visit 18.4% + 4.2% 366,500

100.0% 1,991,800

Location of Most Recent Medical VisitDoctor's Office 68.3% + 5.2% 1,109,400 Urgent Care Center 11.0% + 3.9% 179,400 Public Clinic 6.1% + 2.5% 99,500 Hospital Emergency Room 6.3% + 2.9% 101,600 Other Hospital 1.5% + 1.0% 25,000 Other 6.8% + 2.7% 110,400 Total, All Utahns Who Had a Medical Visit 100.0% 1,625,300

Type of Clinician Who Provided Care (Most Recent Medical Visit)Medical Doctor 87.9% + 3.7% 1,428,600 Nurse Practitioner/Physician's Assistant 11.0% + 3.6% 179,300 Someone Else 1.1% + 0.9% 17,400 Total, All Utahns Who Had a Medical Visit 100.0% 1,625,300

Was Most Recent Medical Visit Covered by Health Insurance? (Insured Persons With Medical Visit Only)Visit Covered 88.0% + 4.6% 1,430,400 Visit Not Covered 12.0% + 4.6% 194,900 Total, All Insured Utahns Who Had a Medical Visit 100.0% 1,625,300

Was There Surgery During the Visit (Including Bone Setting or Stitches)?Yes 7.6% + 3.5% 124,000 No 92.4% + 3.5% 1,501,300 Total, All Utahns Who Had a Medical Visit 100.0% 1,625,300

Had an overnight hospital stay in the previous 12 months?Had a visit 3.8% + 1.4% 76,100 Did not have a visit 96.2% + 1.4% 1,915,700

100.0% 1,991,800

Was Hospital Visit Covered by Health Insurance? (Insured Persons Only With Hospital Stay Only)Visit Covered 95.0% + 9.6% 72,300 Visit Not Covered *** + *** ***Total, All Insured Utahns Who Had a Hospital Visit 100.0% 76,100

1 Rounded to the nearest 100 persons.2 Plus or minus 95% confidence interval3 Figures in these columns may not sum to the totals because of missing values on the grouping variables.*** Sample size insufficient to produce reliable population estimates.


Table 11. Number of Medical Visits: Number of Outpatient Medical Visits in the Past 12 Months*by Sex and Age. Utah 1996.


Survey Estimates of Number of Medical Visits in Past 12 Months


Number of

Persons1

Average Number of Medical Visits,

Past 12 Months2

Total Number of

Medical

Visits1, 3

Percentage Distribution of Medical

Visits by Category

Number of Medical Visits in the Previous 12 MonthsNone 18.4% 366,500 One to Three 53.3% 1,061,000 Four or More 28.3% 564,300 Total, All Utahns 100.0% 1,991,800

Number of Medical Visits inthe Previous 12 Months 100.0% 1,991,800 3.4 + 0.4 6,831,900 100.0%

SexMales 49.5% 986,400 2.9 + 0.6 2,870,400 41.8%Females 50.5% 1,005,400 4.0 + 0.6 3,991,400 58.2%Total, All Utahns 100.0% 1,991,800 3.4 + 0.4 6,831,900 100.0%

Age Group17 and Under 32.6% 648,600 3.3 + 0.6 2,108,000 30.2%18 to 34 27.2% 541,100 3.6 + 0.9 1,931,700 27.7%35 to 49 20.3% 403,900 2.7 + 0.8 1,082,500 15.5%50 to 64 10.6% 211,700 3.5 + 0.9 741,000 10.6%65 and Over 9.4% 186,500 6.0 + 2.5 1,109,700 15.9%Total, All Utahns 100.0% 1,991,800 3.4 + 0.4 6,831,900 100.0%

Sex and AgeMales, 17 and Under 16.7% 332,900 3.1 + 0.7 1,045,300 14.9%Males, 18 to 34 13.4% 267,600 2.1 + 0.8 548,600 7.8%Males, 35 to 49 10.1% 201,200 2.0 + 0.9 396,400 5.7%Males, 50 to 64 5.2% 103,900 3.4 + 1.2 352,200 5.0%Males, 65 and Over 4.1% 80,900 7.4 + 4.4 600,300 8.6%Females, 17 and Under 15.8% 315,700 3.4 + 1.1 1,060,800 15.1%Females, 18 to 34 13.7% 273,400 5.1 + 1.3 1,402,500 20.0%Females, 35 to 49 10.2% 202,700 3.5 + 1.5 715,500 10.2%Females, 50 to 64 5.4% 107,900 3.6 + 1.2 389,500 5.6%Females, 65 and Over 5.3% 105,600 4.7 + 2.5 493,200 7.0%Total, All Utahns 100.0% 1,991,800 3.4 + 0.4 6,831,900 100.0%




Note: Number of visits does not include overnight hospital stays.

* Outpatient medical visits included visits with a medical doctor, defined as, "general practitioners, as well as specialists (such as

dermatologists, etc.) and osteopaths. Do not include visits to a dentist, chiropractor, psychotherapist, or other non-medical doctors."


Table 12. Number of Medical Visits: Number of OutpatientMedical Visits in the Past 12 Months*by Selected Demographic Characteristics. Utah 1996.




Number of

Persons1


Past 12 Months2

Total Number of

Medical

Visits1, 3

Percentage Distribution of Medical

Visits by Category

Local Health DistrictBear River 6.1% 122,300 2.8 + 1.0 347,300 5.1%Central 2.9% 58,600 4.1 + 1.9 242,000 3.5%Davis 11.0% 219,900 3.1 + 1.0 681,700 10.0%Salt Lake 41.3% 823,400 3.3 + 0.7 2,684,300 39.3%Southeastern 2.7% 53,500 4.0 + 1.9 212,400 3.1%Southwest 5.6% 111,100 3.2 + 1.6 354,400 5.2%Summit 1.1% 22,400 5.0 + 2.4 112,000 1.6%Tooele 1.4% 26,900 5.0 + 2.5 134,000 2.0%TriCounty 1.9% 38,500 2.0 + 0.7 75,100 1.1%Utah County 15.9% 316,200 3.1 + 1.1 967,600 14.2%Wasatch 0.6% 12,200 3.9 + 1.6 47,700 0.7%Weber-Morgan 9.4% 186,600 5.2 + 2.0 975,900 14.3%Total, All Utahns 100.0% 1,991,800 3.4 + 0.4 6,831,900 100.0%

Health Insurance StatusInsured 90.5% 1,802,000 3.4 + 0.5 6,180,900 91.6%Uninsured 9.5% 189,800 3.0 + 0.9 563,700 8.4%Total, All Utahns 100.0% 1,991,800 3.4 + 0.4 6,831,900 100.0%


<=100% 7.1% 141,400 5.7 + 2.3 807,400 11.8%101%-200% 27.3% 543,600 4.0 + 0.9 2,179,800 31.8%201%-300% 26.8% 533,600 3.0 + 0.9 1,574,100 22.9%>=301% 38.8% 772,800 3.0 + 0.6 2,302,900 33.5%Total, All Utahns 100.0% 1,991,800 3.4 + 0.4 6,831,900 100.0%

Annual Household Income<=$15,000 6.7% 133,300 5.5 + 2.3 735,800 10.8%$15,000-$35,000 29.9% 595,300 4.5 + 1.0 2,684,800 39.4%$35,000-$55,000 33.3% 663,300 2.8 + 0.7 1,824,100 26.8%>=$55,000 30.1% 599,500 2.6 + 0.5 1,570,700 23.0%Total, All Utahns 100.0% 1,991,800 3.4 + 0.4 6,831,900 100.0%

Education Level (Age 18 and Over)High School Grad or Less 36.5% 490,300 3.6 + 1.0 1,779,800 37.3%Some College or Vocation Degree 37.3% 501,000 3.5 + 0.8 1,773,500 37.2%Four-Year College Graduate 26.2% 351,900 3.5 + 1.2 1,214,100 25.5%Total, Adult Utahns (Age 18+) 100.0% 1,343,200 3.5 + 0.6 4,754,900 100.0%

Marital Status (Age 18 and over)Married 68.4% 918,700 3.7 + 0.7 3,353,300 70.7%Divorced, Widowed, Separated 13.4% 180,000 4.3 + 1.6 770,400 16.2%Never Married 18.2% 244,500 2.5 + 1.1 621,000 13.1%Total, Adult Utahns (Age 18+) 100.0% 1,343,200 3.5 + 0.6 4,754,900 100.0%


Wasatch Front 77.3% 1,539,500 3.4 + 0.5 5,249,700 76.8%Non-Wasatch Front 22.7% 452,100 3.5 + 0.7 1,586,900 23.2%Total, All Utahns 100.0% 1,991,800 3.4 + 0.4 6,831,900 100.0%










Table 13. Number of Medical Visits: Number of OutpatientMedical Visits in the Past 12 Months*by Primary Provider, Access and Health Status. Utah 1996.




Number of

Persons1


Past 12 Months2

Total Number of

Medical

Visits1, 3


Medical Visits by Category

Primary Provider or Usual Place of CareHas Primary Provider 82.2% 1,637,300 3.6 + 0.5 5,812,400 85.4%No Primary Provider 17.8% 354,500 2.8 + 0.8 996,100 14.6%Total, All Utahns 100.0% 1,991,800 3.4 + 0.4 6,831,900 100.0%

Any Access ProblemNo Problem Accessing Care 97.6% 1,944,000 *** + *** *** ***Problem Accessing Care 2.4% 47,800 3.4 + 0.4 163,000 2.4%Total, All Utahns 100.0% 1,991,800 3.4 + 0.4 6,831,900 100.0%

General Health StatusVery Good, Excellent 70.0% 1,394,300 2.7 + 0.3 3,722,800 52.5%Good, Fair, Poor 30.0% 597,500 5.6 + 1.4 3,369,900 47.5%Total, All Utahns 100.0% 1,991,800 3.4 + 0.4 6,831,900 100.0%


Average or Above Average 81.2% 1,090,700 2.6 + 0.5 2,857,600 62.1%Below Average Physical Health 18.8% 252,500 6.9 + 2.1 1,742,300 37.9%Total, Adult Utahns (Age 18+) 100.0% 1,343,200 3.5 + 0.6 4,754,900 100.0%


Average or Above Average 83.1% 1,116,200 3.3 + 0.6 3,650,000 75.7%Below Average Mental Health 16.9% 227,000 5.2 + 1.8 1,173,600 24.3%Total, Adult Utahns (Age 18+) 100.0% 1,343,200 3.5 + 0.6 4,754,900 100.0%


Medical Condition 20.9% 416,300 6.3 + 1.6 2,614,400 37.0%No Medical Condition 79.1% 1,575,500 2.8 + 0.4 4,442,900 63.0%Total, All Utahns 100.0% 1,991,800 3.4 + 0.4 6,831,900 100.0%













Table 14. Routine Preventive Health Care: Percentage of Persons WhoHad a Routine Preventive Health Visit in the Past 12 Monthsby Sex and Age. Utah 1996.


Survey Estimates of Utahns Who Had a Routine Preventive Visit in the Past 12 Months


Number of

Persons1

Percentage of Persons With

Preventive Visit2

Number of

Persons1, 3

Percentage Distribution of Persons With

Preventive Visitby Category

Routine Preventive Health Visit in the Previous 12 Months?Had Preventive Health Visit 55.8% 1,110,400 No Preventive Health Visit 44.3% 881,400 Total, All Utahns 100.0% 1,991,800

Had Routine Preventive Health Visit in the Previous 12 Months 100.0% 1,991,800 55.8% + 5.5% 1,110,400 100.0%

SexMales 49.5% 986,400 52.5% + 8.4% 518,000 46.6%Females 50.5% 1,005,400 59.2% + 7.1% 594,700 53.4%Total, All Utahns 100.0% 1,991,800 55.8% + 5.5% 1,110,400 100.0%

Age Group17 and Under 32.6% 648,600 54.9% + 9.0% 355,800 31.9%18 to 34 27.2% 541,100 50.0% + 11.3% 270,500 24.2%35 to 49 20.3% 403,900 51.6% + 13.2% 208,300 18.7%50 to 64 10.6% 211,700 57.8% + 18.8% 122,300 11.0%65 and Over 9.4% 186,500 85.5% + 5.9% 159,400 14.3%Total, All Utahns 100.0% 1,991,800 55.8% + 5.5% 1,110,400 100.0%

Sex and AgeMales, 17 and Under 16.7% 332,900 55.7% + 13.3% 185,500 16.6%Males, 18 to 34 13.4% 267,600 41.0% + 16.2% 109,700 9.8%Males, 35 to 49 10.1% 201,200 52.7% + 19.2% 106,100 9.5%Males, 50 to 64 5.2% 103,900 42.5% + 27.9% 44,200 4.0%Males, 65 and Over 4.1% 80,900 93.5% + 5.3% 75,600 6.8%Females, 17 and Under 15.8% 315,700 53.9% + 12.1% 170,300 15.3%Females, 18 to 34 13.7% 273,400 59.4% + 15.4% 162,300 14.5%Females, 35 to 49 10.2% 202,700 50.2% + 17.3% 101,800 9.1%Females, 50 to 64 5.4% 107,900 72.4% + 14.8% 78,100 7.0%Females, 65 and Over 5.3% 105,600 78.7% + 9.0% 83,100 7.4%Total, All Utahns 100.0% 1,991,800 55.8% + 5.5% 1,110,400 100.0%




Note: A routine preventive health visit was described to the respondent as a "well visit, that is a routine medical check-up."


Table 15. Routine Preventive Health Care: Percentage of Persons WhoHad a Routine Preventive Health Visit in the Past 12 Monthsby Selected Demographic Characteristics. Utah 1996.




Number of

Persons1


Preventive Visit2Number of

Persons1, 3



Local Health DistrictBear River 6.1% 122,300 54.8% + 14.1% 67,000 6.0%Central 2.9% 58,600 63.0% + 13.3% 36,900 3.3%Davis 11.0% 219,900 53.5% + 12.5% 117,600 10.6%Salt Lake 41.3% 823,400 55.3% + 10.9% 455,400 41.0%Southeastern 2.7% 53,500 63.5% + 13.4% 33,900 3.1%Southwest 5.6% 111,100 55.1% + 13.9% 61,200 5.5%Summit 1.1% 22,400 66.6% + 12.4% 14,900 1.3%Tooele 1.4% 26,900 60.6% + 14.7% 16,300 1.5%TriCounty 1.9% 38,500 52.9% + 15.0% 20,400 1.8%Utah County 15.9% 316,200 50.7% + 13.2% 160,200 14.4%Wasatch 0.6% 12,200 54.8% + 13.3% 6,700 0.6%Weber-Morgan 9.4% 186,600 64.0% + 13.2% 119,500 10.8%Total, All Utahns 100.0% 1,991,800 55.8% + 5.5% 1,110,400 100.0%

Health Insurance StatusInsured 90.5% 1,802,000 55.6% + 5.9% 1,002,100 90.4%Uninsured 9.5% 189,800 56.0% + 16.3% 106,200 9.6%Total, All Utahns 100.0% 1,991,800 55.8% + 5.5% 1,110,400 100.0%


<=100% 7.1% 141,400 64.5% + 20.8% 91,300 8.0%101%-200% 27.3% 543,600 63.8% + 9.7% 347,000 30.5%201%-300% 26.8% 533,600 40.9% + 10.6% 218,100 19.2%>=301% 38.8% 772,800 62.3% + 8.8% 481,100 42.3%Total, All Utahns 100.0% 1,991,800 55.8% + 5.5% 1,110,400 100.0%

Annual Household Income<=$15,000 6.7% 133,300 69.5% + 20.2% 92,700 8.3%$15,000-$35,000 29.9% 595,300 58.7% + 9.2% 349,400 31.4%$35,000-$55,000 33.3% 663,300 54.5% + 9.7% 361,400 32.4%>=$55,000 30.1% 599,500 51.8% + 11.3% 310,700 27.9%Total, All Utahns 100.0% 1,991,800 55.8% + 5.5% 1,110,400 100.0%




Wasatch Front 77.3% 1,539,500 55.3% + 6.9% 850,900 76.7%Non-Wasatch Front 22.7% 452,100 57.3% + 6.1% 259,200 23.3%Total, All Utahns 100.0% 1,991,800 55.8% + 5.5% 1,110,400 100.0%








Table 16. Routine Preventive Health Care: Percentage of Persons WhoHad a Routine Preventive Health Visit in the Past 12 Monthsby Primary Provider, Access and Health Status. Utah 1996.





Number of

Persons1


Preventive Visit2Number of

Persons1, 3



Primary Provider or Usual Place of CareHas Primary Provider 82.2% 1,637,300 59.0% + 6.1% 966,300 86.7%No Primary Provider 17.8% 354,500 41.9% + 13.9% 148,600 13.3%Total, All Utahns 100.0% 1,991,800 55.8% + 5.5% 1,110,400 100.0%

Any Access ProblemNo Problem Accessing Care 97.6% 1,944,000 55.7% + 5.6% 1,083,000 97.1%Problem Accessing Care 2.4% 47,800 68.1% + 26.2% 32,600 2.9%Total, All Utahns 100.0% 1,991,800 55.8% + 5.5% 1,110,400 100.0%

General Health StatusVery Good, Excellent 70.0% 1,394,300 54.8% + 6.6% 763,800 68.6%Good, Fair, Poor 30.0% 597,500 58.6% + 10.0% 350,000 31.4%Total, All Utahns 100.0% 1,991,800 55.8% + 5.5% 1,110,400 100.0%






Medical Condition 20.9% 416,300 72.8% + 9.6% 303,100 26.9%No Medical Condition 79.1% 1,575,500 52.2% + 6.4% 821,900 73.1%Total, All Utahns 100.0% 1,991,800 55.8% + 5.5% 1,110,400 100.0%










Table 17. Hospitalization: Percentage of Persons Who Had An Overnight Hospital Stay in the Past 12 Monthsby Sex and Age. Utah 1996.


Survey Estimates of Utahns Who Were Hosptialized in the Previous 12 Months


Number of

Persons1

Percentage of Persons Who

Had Been

Hospitalized2

Number of

Persons1, 3


Persons Who Had Been Hospitalized

by Category

Overnight Hospital Stay in the Previous 12 Months?Hospital Stay 3.8% 76,100 No Hospital Stay 96.2% 1,915,700 Total, All Utahns 100.0% 1,991,800

Had Overnight Hospital Stay in the Previous 12 Months 100.0% 1,991,800 3.8% + 1.4% 76,100 100.0%


Age Group17 and Under 32.6% 648,600 2.7% + 1.4% 17,800 23.4%18 to 34 27.2% 541,100 *** + *** *** ***35 to 49 20.3% 403,900 2.3% + 2.2% 9,400 12.4%50 to 64 10.6% 211,700 5.0% + 4.3% 10,500 13.8%65 and Over 9.4% 186,500 19.2% + 12.2% 35,700 46.9%Total, All Utahns 100.0% 1,991,800 3.8% + 1.4% 76,100 100.0%

Sex and AgeMales, 17 and Under 16.7% 332,900 2.0% + 1.5% 6,700 8.8%Males, 18 to 34 13.4% 267,600 *** + *** *** ***Males, 35 to 49 10.1% 201,200 *** + *** *** ***Males, 50 to 64 5.2% 103,900 *** + *** *** ***Males, 65 and Over 4.1% 80,900 25.0% + 23.1% 20,200 26.5%Females, 17 and Under 15.8% 315,700 3.6% + 2.6% 11,300 14.8%Females, 18 to 34 13.7% 273,400 *** + *** *** ***Females, 35 to 49 10.2% 202,700 *** + *** *** ***Females, 50 to 64 5.4% 107,900 *** + *** *** ***Females, 65 and Over 5.3% 105,600 14.2% + 9.9% 15,000 19.7%Total, All Utahns 100.0% 1,991,800 3.8% + 1.4% 76,100 100.0%




Note: An overnight hospital stay was defined as being "a patient in a hospital overnight for any reason other than giving birth."*** Sample size insufficient to produce reliable population estimates.


Table 18. Hospitalization: Percentage of Persons Who HadAn Overnight Hospital Stay in the Past 12 Monthsby Selected Demographic Characteristics. Utah 1996.


Survey Estimates of Utahns Who Were Hosptialized in the Past 12 Months


Number of

Persons1


Had Been

Hospitalized2

Number of

Persons1, 3



by Category

Local Health DistrictBear River 6.1% 122,300 1.9% + 1.8% 2,400 3.2%Central 2.9% 58,600 11.3% + 8.9% 6,600 8.7%Davis 11.0% 219,900 4.3% + 3.9% 9,500 12.5%Salt Lake 41.3% 823,400 *** + *** *** ***Southeastern 2.7% 53,500 6.7% + 6.6% 3,600 4.7%Southwest 5.6% 111,100 5.5% + 4.1% 6,100 8.0%Summit 1.1% 22,400 2.6% + 2.6% 600 0.8%Tooele 1.4% 26,900 11.1% + 8.1% 3,000 3.9%TriCounty 1.9% 38,500 6.9% + 5.2% 2,600 3.4%Utah County 15.9% 316,200 *** + *** *** ***Wasatch 0.6% 12,200 9.6% + 7.1% 1,200 1.6%Weber-Morgan 9.4% 186,600 10.7% + 7.1% 20,000 26.3%Total, All Utahns 100.0% 1,991,800 3.8% + 1.4% 76,100 100.0%

Health Insurance StatusInsured 90.5% 1,802,000 3.9% + 1.5% 70,300 92.4%Uninsured 9.5% 189,800 *** + *** *** ***Total, All Utahns 100.0% 1,991,800 3.8% + 1.4% 76,100 100.0%


<=100% 7.1% 141,400 11.1% + 7.9% 15,700 20.6%101%-200% 27.3% 543,600 3.8% + 2.4% 20,400 26.8%201%-300% 26.8% 533,600 *** + *** *** ***>=301% 38.8% 772,800 3.2% + 1.7% 24,900 32.7%Total, All Utahns 100.0% 1,991,800 3.8% + 1.4% 76,100 100.0%


Education Level (Age 18 and Over)High School Grad or Less 36.5% 490,300 4.8% + 2.9% 23,500 39.7%Some College or Vocation Degree 37.3% 501,000 3.1% + 2.2% 15,400 26.0%Four-Year College Graduate 26.2% 351,900 *** + *** *** ***Total, Adult Utahns (Age 18+) 100.0% 1,343,200 4.4% + 2.0% 59,200 100.0%

Marital Status (Age 18 and over)Married 68.4% 918,700 4.0% + 2.5% 36,700 62.0%Divorced, Widowed, Separated 13.4% 180,000 11.2% + 6.6% 20,200 34.1%Never Married 18.2% 244,500 *** + *** *** ***Total, Adult Utahns (Age 18+) 100.0% 1,343,200 4.4% + 2.0% 59,200 100.0%








Note: Hospitalization was defined as being "a patient in a hospital overnight for any reason other than giving birth."


Table 19. Hospitalization: Percentage of Persons Who HadAn Overnight Hospital Stay in the Past 12 Monthsby Primary Provider, Access and Health Status. Utah 1996.


Survey Estimates of Utahns Who Were Hosptialized in the Past 12 Months



Number of

Persons1


Had Been

Hospitalized2

Number of

Persons1, 3



by Category

Primary Provider or Usual Place of CareHas Primary Provider 82.2% 1,637,300 4.1% + 1.7% 67,600 91.6%No Primary Provider 17.8% 354,500 1.7% + 1.6% 6,200 8.4%Total, All Utahns 100.0% 1,991,800 3.8% + 1.4% 76,100 100.0%

Any Access ProblemNo Problem Accessing Care 97.6% 1,944,000 3.9% + 1.5% 74,800 98.3%Problem Accessing Care 2.4% 47,800 *** + *** *** ***Total, All Utahns 100.0% 1,991,800 3.8% + 1.4% 76,100 100.0%














5 Medical conditions include Alzheimer's disease, asthma, diabetes, chronic obstructive pulmonary disease, arthritis, stroke, heart

disease, hearing impairment, vision impairment, and speech impairment.

Note: Hospitalization was defined as being "a patient in a hospital overnight for any reason other than giving birth."*** Sample size insufficient to produce reliable population estimates.


Table 20. Poor Mental Health Status: Percentage of Persons Whose Mental HealthScore on the SF12 Was Poorer Than Average (Below Average Mental Health Status)by Sex and Age. Utah Adults (Age 18 or Over), 1996.


Survey Estimates of Utahns Who Reported Below Average Mental Health


Number of

Persons1


Below Average

Mental Health2

Number of

Persons1, 3


Persons With Below Avg. Mental Health

by Category

Mental Health Status as Measured by the MOS SF-12Above Average 15.7% 210,900 Average 67.5% 906,700 Below Average 16.9% 226,600 Total, Adult Utahns (Age 18+) 100.0% 1,343,200

Below Average Mental HealthStatus on MOS SF-12 100.0% 1,343,200 16.9% + 1.4% 226,600 100.0%

SexMales 48.7% 653,600 13.7% + 2.1% 89,300 39.4%Females 51.3% 689,600 19.9% + 2.0% 137,400 60.6%Total, Adult Utahns (Age 18+) 100.0% 1,343,200 16.9% + 1.4% 226,600 100.0%

Age Group18 to 34 40.3% 541,100 17.7% + 2.3% 95,700 42.4%35 to 49 30.1% 403,900 17.7% + 2.7% 71,600 31.7%50 to 64 15.8% 211,700 15.4% + 3.6% 32,500 14.4%65 and Over 13.9% 186,500 14.0% + 3.3% 26,000 11.5%Total, Adult Utahns (Age 18+) 100.0% 1,343,200 16.9% + 1.4% 226,600 100.0%

Sex and AgeMales, 18 to 34 19.9% 267,600 14.3% + 3.3% 38,100 16.9%Males, 35 to 49 15.0% 201,200 15.4% + 3.9% 31,000 13.7%Males, 50 to 64 7.7% 103,900 11.7% + 5.3% 12,200 5.4%Males, 65 and Over 6.0% 80,900 9.2% + 3.5% 7,400 3.3%Females, 18 to 34 20.4% 273,400 21.1% + 3.2% 57,700 25.6%Females, 35 to 49 15.1% 202,700 20.1% + 3.6% 40,700 18.0%Females, 50 to 64 8.0% 107,900 18.8% + 4.9% 20,300 9.0%Females, 65 and Over 7.9% 105,600 17.5% + 5.0% 18,400 8.1%Total, Adult Utahns (Age 18+) 100.0% 1,343,200 16.9% + 1.4% 226,600 100.0%




Note: Below average mental health was defined using the Medical Outcomes Study (MOS) SF-12 scale. For more information

see Bureau of Surveillance and Analysis. (1997). Health Status in Utah: The Medical Outcomes Study SF-12 (1996 Health

Status Survey Report). Salt Lake City, UT: Utah Department of Health.


Table 21. Poor Mental Health Status: Percentage of Persons Whose Mental HealthScore on the SF12 Was Poorer Than Average (Below Average Mental Health Status)by Selected Demographic Characteristics. Utah Adults (Age 18 or Over), 1996.




Number of

Persons1


Below Average

Mental Health2

Number of

Persons1, 3

Percentage Distribution of Persons With Below Avg. Mental

Healthby Category

Local Health DistrictBear River 6.0% 80,000 15.3% + 3.4% 12,300 5.4%Central 2.9% 39,100 16.4% + 3.4% 6,400 2.8%Davis 10.8% 145,100 14.9% + 3.4% 21,600 9.5%Salt Lake 42.1% 565,400 17.3% + 2.8% 97,900 43.2%Southeastern 2.7% 36,200 18.6% + 3.6% 6,700 3.0%Southwest 5.7% 76,200 17.0% + 3.7% 13,000 5.7%Summit 1.2% 15,600 13.5% + 3.5% 2,100 0.9%Tooele 1.4% 18,500 19.1% + 3.7% 3,500 1.5%TriCounty 1.8% 24,700 19.7% + 3.9% 4,900 2.2%Utah County 15.2% 204,500 17.5% + 3.8% 35,800 15.8%Wasatch 0.6% 8,100 15.1% + 3.2% 1,200 0.5%Weber-Morgan 9.6% 128,900 16.4% + 3.8% 21,100 9.3%Total, Adult Utahns (Age 18+) 100.0% 1,343,200 16.9% + 1.4% 226,600 100.0%

Health Insurance StatusInsured 90.5% 1,215,200 16.0% + 1.5% 194,300 86.4%Uninsured 9.5% 128,000 23.8% + 5.3% 30,500 13.6%Total, Adult Utahns (Age 18+) 100.0% 1,343,200 16.9% + 1.4% 226,600 100.0%


<=100% 7.1% 95,400 32.5% + 7.0% 31,000 13.1%101%-200% 27.3% 366,600 21.5% + 3.5% 78,900 33.2%201%-300% 26.8% 359,800 15.0% + 2.9% 53,900 22.7%>=301% 38.8% 521,200 14.1% + 2.1% 73,500 31.0%Total, Adult Utahns (Age 18+) 100.0% 1,343,200 16.9% + 1.4% 226,600 100.0%

Annual Household Income<=$15,000 6.7% 89,900 32.2% + 6.1% 28,900 12.5%$15,000-$35,000 29.9% 401,500 20.1% + 2.9% 80,900 35.1%$35,000-$55,000 33.3% 447,300 16.6% + 2.7% 74,300 32.2%>=$55,000 30.1% 404,300 11.4% + 2.4% 46,300 20.1%Total, Adult Utahns (Age 18+) 100.0% 1,343,200 16.9% + 1.4% 226,600 100.0%




Wasatch Front 77.3% 1,038,200 16.9% + 1.8% 175,000 77.3%Non-Wasatch Front 22.7% 304,900 16.9% + 1.5% 51,500 22.7%Total, Adult Utahns (Age 18+) 100.0% 1,343,200 16.9% + 1.4% 226,600 100.0%







Table 22. Poor Mental Health Status: Percentage of Persons Whose Mental HealthScore on the SF12 Was Poorer Than Average (Below Average Mental Health Status)by Primary Provider, Problems With Access, and Health Status.Utah Adults (Age 18 or Over), 1996.




Number of

Persons1


Below Average

Mental Health2

Number of

Persons1, 3


Below Avg. Mental Health

by Category

Primary Provider or Usual Place of CareHas Primary Provider 79.5% 1,067,800 16.4% + 2.0% 175,300 79.0%No Primary Provider 20.5% 275,400 16.9% + 4.1% 46,500 21.0%Total, Adult Utahns (Age 18+) 100.0% 1,343,200 16.9% + 1.4% 226,600 100.0%

Any Access ProblemNo Problem Accessing Care 97.0% 1,302,900 15.6% + 1.8% 203,300 91.8%Problem Accessing Care 3.0% 40,300 45.2% + 13.5% 18,200 8.2%Total, Adult Utahns (Age 18+) 100.0% 1,343,200 16.9% + 1.4% 226,600 100.0%

General Health StatusVery Good, Excellent 64.0% 859,600 12.6% + 1.6% 107,900 47.3%Good, Fair, Poor 36.0% 483,600 24.8% + 2.8% 120,100 52.7%Total, Adult Utahns (Age 18+) 100.0% 1,343,200 16.9% + 1.4% 226,600 100.0%




Medical Condition 30.1% 404,300 22.3% + 3.1% 90,300 40.1%No Medical Condition 69.9% 938,900 14.4% + 1.6% 134,700 59.9%Total, Adult Utahns (Age 18+) 100.0% 1,343,200 16.9% + 1.4% 226,600 100.0%









Table 23. Mental Health Care Utilization: Percentage of PersonsWho Sought Mental Health Care in the Past 12 Monthsby Sex and Age. Utah Adults (Age 18 or Over), 1996.


Survey Estimates of Adult Utahns Who Sought Mental Health Care



Number of

Persons1

Percentage of Adults Who

Sought Mental

Health Care2

Number of

Persons1, 3

Percentage Distribution of Adults Who Sought Mental

Health Careby Category

Average or Above Avg Mental Health StatusDid Not Seek Care 78.9% 1,059,700 Sought Mental Health Care 4.3% 58,200

Below Average Mental Health StatusSought Mental Health Care 4.4% 58,700 Considered But Did Not Seek Care 2.8% 37,500 Did Not Consider Seeking Care 9.6% 129,100

Total, Adult Utahns (Age 18+) 100.0% 1,343,200

Sought Mental Health Care inthe Previous 12 Months 100.0% 1,343,200 9.1% + 1.1% 122,800 100.0%

SexMales 48.7% 653,600 7.1% + 1.5% 46,500 37.9%Females 51.3% 689,600 11.1% + 1.6% 76,300 62.1%Total, Adult Utahns (Age 18+) 100.0% 1,343,200 9.1% + 1.1% 122,800 100.0%

Age Group18 to 34 40.3% 541,100 8.8% + 1.6% 47,300 38.6%35 to 49 30.1% 403,900 10.5% + 2.1% 42,200 34.5%50 to 64 15.8% 211,700 9.1% + 3.1% 19,200 15.7%65 and Over 13.9% 186,500 7.3% + 2.7% 13,700 11.2%Total, Adult Utahns (Age 18+) 100.0% 1,343,200 9.1% + 1.1% 122,800 100.0%

Sex and AgeMales, 18 to 34 19.9% 267,600 6.9% + 2.2% 18,500 15.1%Males, 35 to 49 15.0% 201,200 6.5% + 2.4% 13,000 10.6%Males, 50 to 64 7.7% 103,900 8.9% + 4.9% 9,300 7.6%Males, 65 and Over 6.0% 80,900 6.9% + 4.5% 5,600 4.6%Females, 18 to 34 20.4% 273,400 10.6% + 2.3% 28,900 23.6%Females, 35 to 49 15.1% 202,700 14.5% + 3.3% 29,300 23.9%Females, 50 to 64 8.0% 107,900 9.2% + 3.8% 9,900 8.1%Females, 65 and Over 7.9% 105,600 7.7% + 3.3% 8,100 6.6%Total, Adult Utahns (Age 18+) 100.0% 1,343,200 9.1% + 1.1% 122,800 100.0%




Note: Below average mental health was defined using the Medical Outcomes Study (MOS) SF-12 scale. For more information

see Bureau of Surveillance and Analysis. (1997). Health Status in Utah: The Medical Outcomes Study SF-12 (1996 Health

Status Survey Report). Salt Lake City, UT: Utah Department of Health.


Table 24. Mental Health Care Utilization: Percentage of PersonsWho Sought Mental Health Care in the Past 12 Monthsby Selected Demographic Characteristics. Utah Adults (Age 18 or Over), 1996.





Number of

Persons1


Sought Mental

Health Care2

Number of

Persons1, 3



Local Health DistrictBear River 6.0% 80,000 7.1% + 2.4% 5,700 4.6%Central 2.9% 39,100 6.1% + 2.1% 2,400 2.0%Davis 10.8% 145,100 9.1% + 2.7% 13,200 10.8%Salt Lake 42.1% 565,400 11.1% + 2.2% 62,500 50.9%Southeastern 2.7% 36,200 7.3% + 2.2% 2,600 2.1%Southwest 5.7% 76,200 8.2% + 2.6% 6,300 5.1%Summit 1.2% 15,600 10.1% + 2.9% 1,600 1.3%Tooele 1.4% 18,500 7.3% + 2.3% 1,400 1.1%TriCounty 1.8% 24,700 5.9% + 2.1% 1,400 1.1%Utah County 15.2% 204,500 6.6% + 2.4% 13,500 11.0%Wasatch 0.6% 8,100 7.9% + 2.7% 600 0.5%Weber-Morgan 9.6% 128,900 9.0% + 2.7% 11,500 9.4%Total, Adult Utahns (Age 18+) 100.0% 1,343,200 9.1% + 1.1% 122,800 100.0%

Health Insurance StatusInsured 90.5% 1,215,200 8.6% + 1.3% 104,900 87.0%Uninsured 9.5% 128,000 12.3% + 4.0% 15,700 13.0%Total, Adult Utahns (Age 18+) 100.0% 1,343,200 9.1% + 1.1% 122,800 100.0%

Persons Who Had Health InsuranceAbove Average Mental Health 14.5% 194,300 4.3% + 2.0% 8,300 8.6%Average Mental Health 62.4% 838,700 5.2% + 1.1% 43,700 45.2%Below Average Mental Health 13.6% 182,200 24.5% + 4.3% 44,700 46.2%Total Insured 90.5% 1,215,200 8.6% + 1.3% 104,900 100.0%

Persons With No Health InsuranceAbove Average Mental Health 2.3% 30,500 *** + *** *** ***Average Mental Health 5.2% 70,500 6.4% + 3.1% 4,500 28.7%Below Average Mental Health 2.0% 27,100 29.4% + 11.6% 8,000 51.0%Total Uninsured 9.5% 128,000 12.3% + 4.0% 15,700 100.0%


<=100% 7.1% 95,400 16.1% + 5.1% 15,300 12.3%101%-200% 27.3% 366,600 10.6% + 2.7% 39,000 31.4%201%-300% 26.8% 359,800 8.6% + 2.3% 30,900 24.9%>=301% 38.8% 521,200 7.5% + 1.5% 39,100 31.5%Total, Adult Utahns (Age 18+) 100.0% 1,343,200 9.1% + 5.1% 122,800 100.0%

Income Less Than 100% of Poverty LevelAbove Average Mental Health 2.3% 31,000 *** + *** *** ***Average Mental Health 3.8% 51,300 8.2% + 5.4% 4,200 27.5%Below Average Mental Health 1.0% 13,100 33.4% + 12.1% 4,400 28.8%Total, Adult Utahns in Poverty 7.1% 95,400 16.1% + 5.1% 15,300 100.0%

Income Greater Than 100% of Poverty LevelAbove Average Mental Health 15.1% 202,400 4.8% + 2.3% 9,700 9.7%Average Mental Health 63.3% 850,600 5.1% + 1.0% 43,000 42.9%Below Average Mental Health 14.5% 194,600 24.4% + 4.5% 47,500 47.4%Total, Adlt Utahns >100% Poverty 92.9% 1,247,600 8.2% + 1.1% 101,700 100.0%







Number of

Persons1


Sought Mental

Health Care2

Number of

Persons1, 3



Annual Household Income<=$15,000 6.7% 89,900 19.0% + 4.9% 17,100 14.1%$15,000-$35,000 29.9% 401,500 9.9% + 2.3% 39,900 33.0%$35,000-$55,000 33.3% 447,300 8.2% + 1.8% 36,500 30.2%>=$55,000 30.1% 404,300 6.8% + 1.8% 27,500 22.7%Total, Adult Utahns (Age 18+) 100.0% 1,343,200 9.1% + 1.1% 122,800 100.0%

Income Under $15,000Above Average Mental Health 0.8% 11,300 *** + *** *** ***

Average Mental Health 3.7% 49,600 10.0% + 5.4% 5,000 29.2%Below Average Mental Health 2.2% 28,900 37.6% + 11.2% 10,900 63.7%Total, Adult Utahns <$15K 6.7% 89,900 19.0% + 4.9% 17,100 100.0%

Income $15,000 to $45,000Above Average Mental Health 7.7% 103,900 6.9% + 2.0% 7,200 11.8%Average Mental Health 31.5% 423,700 5.0% + 1.4% 21,200 34.6%Below Average Mental Health 9.6% 128,900 25.4% + 6.0% 32,800 53.6%Total, Adult Utahns $15K-$45K 48.9% 656,600 9.3% + 1.7% 61,200 100.0%

Income Over $45,000Above Average Mental Health 6.9% 92,600 2.2% + 1.6% 2,100 5.6%Average Mental Health 32.0% 429,700 4.8% + 1.5% 20,700 28.2%Below Average Mental Health 5.4% 72,700 20.6% + 6.8% 15,000 28.5%Total, Adult Utahns >$45K 44.3% 595,000 6.3% + 1.4% 37,700 100.0%




Wasatch Front 77.3% 1,038,200 9.7% + 1.4% 100,200 81.6%Non-Wasatch Front 22.7% 304,900 7.4% + 1.0% 22,600 18.4%Total, Adult Utahns (Age 18+) 100.0% 1,343,200 9.1% + 1.1% 122,800 100.0%






Medical Outcomes Study (MOS) SF-12 measure for physical and mental health status. For more information, see

Bureau of Surveillance and Analysis. (1997). Health Status in Utah: The Medical Outcomes Study SF-12

(1996 Health Status Survey Report). Salt Lake City, UT: Utah Department of Health.



Table 25. Mental Health Care Utilization: Percentage of PersonsWho Sought Mental Health Care in the Past 12 Monthsby Primary Provider, Problems With Access, and Health Status.Utah Adults (Age 18 or Over), 1996.





Number of

Persons1


Sought Mental

Health Care2

Number of

Persons1, 3



Primary Provider or Usual Place of CareHas Primary Provider 79.5% 1,067,800 9.8% + 1.7% 104,600 87.5%No Primary Provider 20.5% 275,400 5.5% + 2.2% 15,000 12.5%Total, Adult Utahns (Age 18+) 100.0% 1,343,200 9.1% + 1.1% 122,800 100.0%

Any Access ProblemNo Problem Accessing Care 97.0% 1,302,900 8.4% + 1.4% 109,700 91.6%Problem Accessing Care 3.0% 40,300 25.1% + 11.9% 10,100 8.4%Total, Adult Utahns (Age 18+) 100.0% 1,343,200 9.1% + 1.1% 122,800 100.0%

General Health StatusVery Good, Excellent 64.0% 859,600 7.2% + 1.2% 61,900 50.4%Good, Fair, Poor 36.0% 483,600 12.6% + 2.2% 61,000 49.6%Total, Adult Utahns (Age 18+) 100.0% 1,343,200 9.1% + 1.1% 122,800 100.0%






Medical Condition 30.1% 404,300 13.3% + 2.5% 53,600 43.4%No Medical Condition 69.9% 938,900 7.4% + 1.1% 69,800 56.6%Total, Adult Utahns (Age 18+) 100.0% 1,343,200 9.1% + 1.1% 122,800 100.0%









Table 26. Primary Reason for Not Seeking Mental Health Services.Utah Adults (Age 18 or Over) Who Had Below Average Mental Health Status and Considered Seeking But Did Not Seek Mental Health Care, 1996.

Survey Estimates for Primary Reason for Not Seeking Help (Based on Only Those Who Reported Problems

and Considered Seeking Help But Did Not)

Reason for Not Seeking Help Percentage Distribution2 Number of Persons1, 3

Cost, Insurance, Financial Reasons 34.3% + 11.1% 12,900 Self-Help 15.8% + 8.1% 5,900 Time Constraints 19.0% + 10.5% 7,100 No Reason, Put it Off 8.2% + 6.6% 3,100 Decided It Was Not Necessary 5.9% + 5.4% 2,200 Did Not Know Where To Go 2.3% + 2.0% 900 Went to M.D., Got Prescription *** + *** ***Other 14.0% + 8.0% 5,300

Total, Adult Utahns With Below Average Mental HealthStatus Who Considered Seeking But Did Not SeekMental Health Care 100.0% 37,500

1 Rounded to the nearest 100 persons.2 Plus or minus 95% confidence interval3 Figures in these columns may not sum to the totals because of missing values on the grouping variables.*** Sample size insufficient to produce reliable population estimates.

TECHNICALNOTES


General Technical Background to the 1996 Health Status Survey

Introduction

The purpose of this section is to provide the reader with a general methodological overview of theproject. Persons interested in obtaining additional or more detailed information may contact:

Bureau of Surveillance and AnalysisOffice of Public Health DataUtah Department of Health

P O Box 142101Salt Lake City, UT 84114-2101

Phone: (801) 538-6108E-mail: [email protected]

Sample Design

The 1996 Utah Health Status Survey represents the third such survey; previous surveys wereconducted in 1986 and 1991. The statistical estimates in this report are based on 1996 Utah HealthStatus Survey data.

The sample was a complex survey sample designed to be representative of all Utahns. It is bestdescribed as a weighted probability sample of approximately 6,300 households disproportionately stratifiedby twelve local health districts that cover the entire state. Five hundred household interviews were con-ducted in each health district, except Salt Lake City/County Health District, in which eight hundred house-hold interviews were conducted in order to increase the precision of statewide estimates.

A single stage, non-clustered, equal probability of selection telephone calling design wasused to generate telephone numbers, more specifically referred to as the Casady-Lepkowski (1993) callingdesign. This method begins by building a base sampling frame consisting of all possible telephone numbersfrom all working prefixes in Utah. Telephone numbers are arranged sequentially into groups of 100 byselecting all telephone numbers within an area code and prefix, plus the first and second digits of the suffix(e.g., 801-538-10XX represents a group that includes all 100 phone numbers between 801-538-1000 and801-538-1099). Each group of 100 telephone numbers is classified as either high density (at least oneresidential listing) or low density (no listed residential phone numbers in the group). All low density groupsare removed, and high density groups are retained. Telephone numbers are randomly selected from thehigh-density list. This sampling design ensures that both listed and unlisted phone numbers are included in

the sample.

The survey interview was conducted with one randomly-selected adult (age 18 or older) in eachhousehold. To select this person, Gallup interviewers collected household membership information from thehousehold contact person (the person who answered the telephone). One household member was thenselected at random from the list of all household members age 18 or over. Survey questions were thenasked about either, 1) all household members, 2) the survey respondent only, 3) a randomly selected adultor child household member (selected using the same method as was used to select the respondent), or 4)the household as a whole. Thus, the survey sample varies, depending on the within-household referencesample that was used for each set of survey questions. Each within-household reference sample has knownprobabilities of selection and can be generalized to the Utah population.


Survey Data Collection

The Utah Department of Health contracted with The Gallup Organization to collect the survey data.Gallup incorporated the telephone survey instrument into a computer-assisted random digit dialingsoftware program, called SURVENT. Interviews were conducted by trained interviewers in a supervisedenvironment across six sites. Interviews were conducted in Spanish when appropriate.

Computer-assisted telephone interviewing was chosen as the method of data collection forseveral reasons. First, it yields higher response rates, thus resulting in a more representative sample andreducing the amount of bias inherent in mail survey response rates. Second, it helps reduce non-samplingerror by standardizing the data collection process. Data-entry errors are reduced because interviewers arenot allowed to enter non-valid codes. It was also efficient because it allowed interviewers to enter re-sponses directly into the database.

The survey questionnaire was divided into core and supplemental modules. Core questionswere asked of all households in the sample. Table 1 describes the types of “core” questions that wereasked, and about whom they were asked. Notice that not all questions were asked with regard toeveryone in the household.

Table 1.CORE MODULE QUESTIONS

Question Topic Within-Household Reference Sample

Demographic characteristics All household membersPresence of chronic medical condition All household membersHealth insurance status All household membersInjury incidence/safety issues All household membersLifestyle (smoking, drinking, exercise) All household membersSubjective mental/physical health (SF12) Respondent only (randomly-selected adult)Health screening exam usage Respondent only (randomly-selected adult)Access to care/primary provider Randomly-selected household member of any ageHousehold-level demographic characteristics The household as a whole

In addition to the core survey questions (above), one of six different supplemental modules wasadministered to primarily non-overlapping randomly-assigned subsets of (approximately 1,000) households.Table 2 shows the types of questions asked in the supplemental module questions, and about whom theywere asked.


Table 2.SUPPLEMENTAL MODULE QUESTIONS

Type of Question Within-Household Reference Sample

Limitations of activities All household membersMigration Respondent only (randomly-selected adult)Health Plan Consumer Satisfaction Respondent only (randomly-selected adult)Fertility Respondent or spouse onlyHealth Care Utilization Randomly-selected household member of any ageInterpersonal violence The household as a whole

*Note: All supplemental module questions were asked only of a subset of households.

While both core and supplemental modules yielded sufficient sample sizes to construct state-levelestimates for the Utah population, the information collected from supplemental modules was not intended foruse in district-level analyses.

Cooperation rate

The interview process took place over a three month period (from June to August, 1996), andresulted in a cooperation rate of 66.3%. If necessary, up to nine telephone attempts were made to contacta selected household. After a randomly-selected survey respondent was identified, up to nine attemptswere made to conduct the interview with that person.

Weighting and Estimation Methods

Post-survey weighting adjustments were made so that the Health Status Survey findings couldbe more accurately generalized to Utah’s population. Two types of post-survey weighting adjustmentswere made, one that adjusted for random sampling variation, and one that adjusted for disproportionatesampling (such as the over-sampling of smaller local health districts across the state). Although the twotypes of adjustment are distinct conceptually, they were accomplished in a single step.

The post-survey weighting adjustments weighted the sample to be proportionately consistent withthe age, sex, geographic, and Hispanic status distribution of the 1996 Utah population. Utah populationestimates by sex, single year of age, and county of residence were provided by the Utah Governor’s Officeof Planning and Budget (GOPB) (the estimates used were those compiled in 1994). Estimates of Utah’sHispanic population for 1996 were derived by calculating the average annual rate of increase of Hispanicpersons for each health district using data from 1990 to 1994 Bureau of the Census reports, and thenprojecting those increases to 1996 GOPB local health district population counts. Total state estimates forHispanic persons were calculated by summing across local health districts.


The post-survey weighting variables adjusted for the following factors:

1. The number of phones in the household.2. The total number of persons in the household to which the data will be generalized (1 for questions

that were asked about every household member, the number of adults in the household for questions thatwere asked only of the respondent, the number of persons in the household for questions that were askedof a randomly-selected household member).

3. The proportion of Hispanic persons in each local health district.4. The age and sex distribution of each local health district.5. The probabilities of selection for each local health district.

Population count estimates. Once a percentage was calculated for a variable of interest (e.g., thepercentage uninsured) using appropriately weighted survey data, a population count (N) to which thepercentage applied was estimated. In some cases analyses referenced certain age or sex groups, Hispanicpersons or combinations of Utah counties. These total population group counts were readily available fromthe sources described earlier. However, for other groups where population counts were largely unavailable(e.g., analyses that examined the distribution of adult males by marital status), the population counts wereestimated. This was achieved by multiplying the appropriate 1996 population total for that group (from1996 GOPB estimates) by a proportion obtained from a frequency distribution or cross tabulation analysisof survey data. For instance, to calculate a population count for adult males who were married, thepopulation of adult males from GOPB was multiplied by percentage of married adult males in the 1996 UtahHealth Status Survey sample. Thus, any population count estimates not derived directly from existing age,sex, Hispanic status or county population estimates were derived from 1996 Health Status Survey data, andmust be considered estimates.

Missing Values. Another consideration that affected the presentation of the population estimatesin table format was the inclusion or exclusion of missing values (“don’t know” and “refused to answer”).Population percentage estimates were calculated after removing the “don’t know” and “refused to answer”responses from the denominator. This, in effect, assumed that persons who gave these answers weredistributed identically on the variable of interest to those who gave a valid answer to that variable. Forinstance, that among those who did not know whether they were insured, we assumed that 90.47% of themwere insured and 9.53% were not insured -- percentages identical to those found among the samplemembers who answered the question with a valid response.

Removing the missing cases from an analysis is rather simple and straightforward for analyses of asingle variable. However, when one variable is cross-tabulated by another variable, all missing cases fromboth variables must be removed from the analysis. Removing the missing cases in itself is not a problem.However, a problem is encountered when a population estimate for a given variable, such as the percentageof all Utahns that have health insurance, differs slightly from an analysis of “all Utahns” versus an analysis of“all Utahns by age group.” This is because the missing cases on the age variable have been removed fromone analysis and not from another. Since the percentage of all Utahns that have health insurance wascalculated on slightly different samples, the resulting percentage estimates are slightly different. This problemwas resolved by reporting the best population estimate available for any given population subgroup. Forinstance, in the table of insurance rates for all Utahns by age, the population estimate from an analysis thatincludes Utahns of all ages, regardless of whether they reported missing values on the age variable has beensubstituted for the original total row in that table. The only drawback to this strategy is that the populationcount figures for Utahns with and without health insurance in tables like the “Utahns by Age Group” table do


not sum to the same number derived from the analysis of all Utahns regardless of whether they had missingvalues on the age variable. As a result, the tables appear as though they do not “add up.”

Limitations and Other Special Considerations

Estimates developed from the sample may differ from the results of a complete census of allhouseholds in Utah due to two types of error, sampling and non-sampling error. Each type of error ispresent in estimates based on a survey sample. Good survey design and data collection techniques serve tominimize both sources of error.

Sampling error refers to random variation that occurs because only a subset of the entirepopulation is sampled and used to estimate the finding in the entire population. It is often mis-termed“margin of error” in popular use. Sampling error is expressed as a confidence interval. The 95%confidence interval (calculated as 1.96 times the standard error of a statistic) indicates the range of valueswithin which the statistic would fall 95% of the time if the researcher were to calculate the statistic (e.g., apercentage) from an infinite number of samples of size=n drawn from the same base population. It istypically expressed as the “plus or minus” term, as in the following example:

“The percentage of those polled who said they would vote for Bill Clinton was 52%, plus orminus 2%.”

Because local health districts were disproportionately stratified and then weighted to reflect the Utahpopulation, the sample was considered a complex survey sample design. Estimating the sampling error for acomplex survey design requires special statistical techniques, derived from the standard error for eachestimate. SUDAAN software (Research Triangle Institute) was chosen to estimate the standard errors ofthe survey estimates because it employs a statistical routine (Taylor-series expansion) that accounts for thecomplex survey design.

Figures in this report include bars showing this estimated confidence interval around the parameterestimate. In cases where the confidence interval was greater in magnitude than the estimate, the estimatewas not given. Estimates were not computed where the sample denominators were less that n=50.Readers should note that we have always presented the confidence interval as though it were symmetric,that is, of equal value both above and below (plus and minus) the estimate. It is often the case, however,that a confidence interval will be nonsymmetric. This occurs when the distribution is positively or negativelyskewed, such as when a percentage is close to 0% or 100%. However, because the software program weuse provides only symmetric confidence intervals, we are unable to provide the asymmetric estimates.

Non-sampling error also exists in survey estimates. Sources of non-sampling error includeidiosyncratic interpretation of survey questions by respondents, variations in interviewer technique,household non-response to questions, coding errors, and so forth. No specific efforts were made toquantify the magnitude of non-sampling error.

Comparability with other surveys is an issue with all surveys. Differences in survey design, surveyquestions, estimation procedures, the socio-demographic and economic context, and changes in thestructure and financing of the health care delivery system may all affect comparison between the 1996 UtahHealth Status Survey and other surveys, including those conducted by the U.S. Bureau of the Census, theBehavioral Risk Factor Surveillance System surveys, and previous Utah Department of Health, HealthStatus Surveys.


Telephone surveys exclude certain population segments from the sampling frame, includingpersons in group living quarters (e.g., military barracks, nursing homes) and households without telephones.At the time of the 1990 Decennial Census, only four percent of Utah households were without telephoneservice. Typically, telephone surveys are biased because telephone households under-represent lowerincome and certain minority populations. In addition, studies have shown that non-telephone householdstend to have lower rates of health care utilization (especially dental care), poorer health habits and healthstatus, and lower rates of health insurance coverage (Thornberry and Massey, 1988).

Despite these overall disparities between telephone and non-telephone households, new surveyresearch (Keeter, 1995) suggests that a similarity exists between data from non-telephone households andtelephone households that experienced an interruption in service over the past 12 months. This similarityexists because many, if not most, households currently without telephones did have service in the recentpast, and will have service again in the future. Therefore, certain households with telephones (those that hada recent interruption in service) are representative of “nonphone” households, allowing health status surveyestimates that have been corrected for telephone noncoverage bias to be produced where indicated.


BIBLIOGRAPHY

Bureau of Surveillance and Analysis. (1997). Health Status in Utah: The Medical Outcomes Study SF12(1996 Utah Health Status Survey Report). Salt Lake City, UT: Utah Department of Health.

Bureau of Surveillance and Analysis. (1997). Socioeconomic Status and Health in Utah (1996 Utah HealthStatus Survey Report). Salt Lake City, UT: Utah Department of Health.

Casady, R.J. & Lepkowski, J.M. (1993) Stratified telephone survey designs. Survey Methodology, 19 (1)103-113.

Keeter, S. (1995) Estimating telephone noncoverage bias with a telephone survey. Public Opinion Quar-terly, 59, 196-217.

Thornberry, O.T. & Massey J.T. (1988) Trends in United States telephone coverage across time andsubgroups. In Robert M. Groves, Paul P. Biemer, Lar E. Lyberg, James T. Massey, William L.Nichols II, and Joseph Waksberg (eds.) Telephone Survey Methodology. New York: John Wileyand Sons.

Williams R. Research Triangle Institute, personal communication, March 1997.

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